Any tips for coping with anxiety during high risk pregnancy?

[TaytoCrisp]

I am 40 and have one beautiful dd. We would love another child but have had two losses in the past year (at 23 wks and then at 14 wks). Tests have been inconclusive, outside of the fact that I have factor v Leiden (thrombophilia) which may have been linked with sudden bleeding in both miscarriages. I was on heparin and aspirin for my last pregnacy but it didn't work and our consultant said there was nothing new that would be offered were I to become pregnant again.

I am very fortunate in that conceiving has never been a problem for us and I'm now trying to decide if we should try one last time. Dh is keen, but also anxious and not sure how he could be supportive if I got pregnant again. I know that any future pregnancy would be very hard, as I would continuously be checking for sudden bleeding in second and third trimesters.. I have been to counselling following the second late mc which was helpful, and could go back there if I needed. However I'm wondering if anyone has any advice on managing anxiety in this type of situation - unfortunately the very thought of pregnancy makes me nervous right now but I feel its now or never so we either try one last time(and prepare for the journey) or accept our family as it is (and be thankful for what we have).

Thank you for reading. Any thoughts/suggestions would be very welcome.

The Six Steps:

1. Expect, allow and accept that fear will arise.
2. When fear comes, stop, wait and let it be.
3. Focus on and do manageable things in the present.
4. Label your level of fear from 0 to 10. Watch it go up and down.
5. Function with fear. Appreciate your achievements.
6. Expect, allow and accept fear reappearing.

Sorry for your losses too

Op, SANDS have some pregnancy after loss support groups to provide support for mothers during their next pregnancy. If you are near London, I can pm you some details. Or google your local SANDS support group to see if they offer these groups.

I had four pregnancies after losing my eldest daughter at 25 weeks. My subsequent pregnancies were high risk, not at all fun.... I just got through it, I don't know how! I just took each day as it came and tried to keep busy.

Wishing you the best of luck....

Thank you so much working and imip for the tips.

Working - The Six Steps sound very helpful. Actually is there anywhere i could read up on this?

imip thanks for reminding me about SANDS. I have contacted them in the past but had forgotten that they might be a good source of support again. I'm not in London but will explore what's available locally. Thank-you.

I read them in a book called 'Dropping the Baby and Other Scary Thoughts'. It's really aimed at people with perinatal anxiety and depression so many of us would not necessarily have a background like yours where fears are based on real life experiences... so I wonder would you find that a bit alienating?

I had perinatal OCD which just basically meant I sort of had the anxiety that you might expect from someone who had experienced loss like yours but without that experience. Yet all my fears were fairly realistic, fearing the potential of harm coming to my baby in ways that reflect the reality of loss that happen to so so many people. In some way this made it hard for me to identify with some of what I read as sometimes people with OCD have very low probability fears, like that they might get a very rare disease or put their baby into the microwave or purposefully drown them. I was just afraid of very normal stuff... mainly stillbirth, because several people in my family had this experience and I had a number of friends who had second trimester losses. This can be tough with some of the techniques because CBT takes the view that obsessive fear = overestimating the probability and/or awfulness of a feared event. Yet of course, does it matter that infant loss is low probability in grand statistical terms when you or people very close to you experience it? And is there anything more awful really than losing a precious baby? Once you know it can happen, you know it can happen... the innocence is gone whether or not you are likely to experience it in real terms. Even a one in a million chance is too high when you have even a taste of how horrendous it is to experience that loss and to a certain extent I think it's very tricky to say that fear in this situation is anything but normal and understandable. Even for me, without actually experiencing that loss personally, at my first son's christening five out of ten women there had experienced stillbirth. You can quote statistics forever that it's unlikely but I am not so naive as to think I have magical protection from pain. In the same way, I was told in CBT my fears were about 'tolerating uncertainty' or 'having difficulty tolerating adversity'. Again, helpful? Realistic? I'm no perfectionist control freak, this is not about my personality or thinking style... I just know it can happen and I can't u know that or feel unafraid.

So all you can do is find a way to bear it. To accept that fear is going to be part and parcel of your experience of pregnancy, to be self compassionate and realise there are good reasons for that and to get in touch with the observer part of yourself who can see your fear and have empathy with it without buying into it and what-iffing/monitoring every second of the day. Although I have to say I still do knicker watch and have several starts a day where even now at nine weeks, knowing rationally I shouldn't feel movement I think 'the baby's not moving'. I just don't pay too much heed to it... I think oh, there I go being terrified again and I feel openheartedly and non-judgementally compassionate about it and bring myself back to the present moment and whatever it is I am doing in my day.

You just have to be very kind to yourself. Books on acceptance and commitment therapy are good, the Reality Slap by Russ Harris is on Kindle Summer sale right now for just over a quid and its really about feeling the fear and doing it anyway. Lots of helpful stuff about not struggling against reality in terms of 'it shouldn't be like this/why do other women get to enjoy pregnancy/why did this happen to me' and the suffering this adds to the understandable root causes of your pain. About living with the root causes... so feeling your grief for the babies you lost and allowing that or in my case feeling grief for the women in my life who lost their babies and myself for having had the sort of childhood characterised by neglect and abuse that leads me to fear the worst even in situations that should be joyous.

Does this make sense?

Working Thank you so much for taking the time to share your experiences. This is incredibly helpful. Everything you say really resonates. I have heard of acceptance and commitment therapy but never really considered it; it sounds like a very helpful approach.

It sounds like you have had a very tough time too; but you also have a lot of insight (and strength I would say). I think your description of CBT is really interesting - so many times DH and I have talked about probabilities of a successful outcome - high , low etc...probabilities given age, previous late losses and other complications... and try to compare with national statistics (which don't really reflect personal situations). I can totally understanding your fears given the experiences of those close to you. And you are right, it is just such a big risk given that the outcome is a baby v. no baby and grief... its all or nothing.

Focusing on accepting and observing anxiety seems to be the most helpful approach as you suggest. It's easy to forget self-compassion too - thank-you for pointing that I. I do tend to be hard on myself and wonder if I should be "Stronger" and not worry so much. But it is much more helpful to acknowledge that this is hard (given our direct/indirect experiences) and we are actually quiet strong in dealing with it.

I will definitely download the book you suggest.

Thank you so much again!

And congratulations on your pregnancy :-)

Hey I've just realised what your username is. Are you a northern or a southern Tayto? I am from Cork.

Southern - from the metropolis, but living in the land of the king crisp!

Lol I am in Seabrooks territory these days, but hopeful of a return to the land of the little yellow man with the red suit. Did you ever try the tayto chocolate, bizarre.

Best of luck with ttc. I think that to have had two such losses, second and third tri, it will take every ounce of strength you can muster and more than could be put into words but if you feel that deep desire go for it. It would be unrealistic to expect a pregnancy without anxiety.. but you can find the deep well of strength in you to bear it and whatever comes from it if you truly want to try again. Though on the other hand, if you chose not to put yourself through that again, coming to terms with not having another baby is something you will find the grace to deal with too. It all sucks that it has to be hard but you can navigate your way through this no matter where the currents take you. Best wishes whatever you choose.

Tayto - for me a combination of keeping very busy, counselling, 'Buddhism for mothers' and supportive DH have helped me so far with my high-risk pregnancy.

That and focusing on this being a different pregnancy - a new hope and new possibility. There is no reason to assume it will be like my others and indeed the complications I have so far are different to the ones I have had before.

Best of luck with whatever you decide.

working - 'the little yellow man with the red suit" :-)! Yes, it's always nice to see him and his striped trousers in the houses of all my friends when I go home!

Thanks again for the helpful advice. I will focus on this in the coming weeks as we try to come to a decision.

holey Thank you also. That book looks like it would have some very good practical tips. Congratulations On your pregnancy, I will be thinking of you.

Hi Ladies, I am classed as High Risk (which I knew I would be) and although I'm trying hard not to focus on my anxieties it is easier said than done.

I'm high risk because I've got Epilepsy and SVT and so am under the watchful eye of various specialists but sometimes being in the Spot Light makes the nerves worse. I have worries about the effects of my medication on the baby as although I did make the decision to come off my Beta Blockers I'm still on my Epilepsy Drugs. My heart rate stability has gone a bit haywire since coming off the Beta Blockers but I'm trying to put it to the back of my mind. In terms of my epilepsy, I have been seizure free for over 7 years but have been warned there is a high chance my seizures will return and I'm sh*tting myself. I would lose my licence and my job would be over and I can't bear the thought of it. I'm worried that if my seizures do come back and ruin my life I'm going to resent the baby. I have also been told there is a 10% chance of having seizures during labour and they are concerned about how my heart will cope with the physical stress of the labour So not many positives really.

I'm just taking it day by day and hoping it all turns out right in the end x

Hi Taytocrisp. No matter how healthy a women is will always be anxious and exited during her pregnancy. In guess if I'm lucky enough to concieve I'll probably be a high risk as I didn't carry D.D well at all I had pre-eclampsia resulting in an emergency c/section. and I was only 20+ then so and I've heard that if you have pre-eclampsia in your first pregnancy than you're likely to get it again but I know the hospital will have the right care to give me and if they have to deliver me early plenty of babies are born early and with lots of medical care they're fine. My attitude is if you panicked about every single thing that could go wrong during pregnancy the world would stop.
I also had a miscarriage which absolutely devestated me it still does. I was carrying an innocent life that was took away. I didn't want another baby either I wanted the one that was growing inside me, the one I would talk to and read to, it may seem crazy because I was only a few weeks pregnant. I purposely waited to ttc untill after my would be due date, as I didn't want to cancel the baby's possible existance, plus if I did try right away and get pregnant I wouldn't have had D.D as it would have been a different sperm different egg. I went on to have my D.D 19 months after the m/c. My daughter is the most amazing child to walk the earth I adore her beyond imagination but she's not a replacement for the baby I lost. I have had many dreams about my lost baby as well. I had one where she kissed me and said she loved me. Although if I'm honest I'm not even entirely sure it was a dream because it was so vivid.

If you do decide to ttc good luck with everything. Try and let us know your decision.
Also writerwannabe. Sorry to hear of your epilepsy, if they're worried about your heart during labour could you not talk to them about having a c/section or would you rather deliver naturally. Also whatever happens there's no chance you'll resent your baby. It stands out a million miles how much this baby means to you. xxx

Gosh that's hard, OP. I'm sorry for your losses. I guess it comes down to whether you would regret most never trying again or living with the possibility of another loss. Some counselling might help you work through your thoughts and give you some coping techniques to help.

writer that sounds like an awful lot to have to cope with; and I imagine it is overwhelming at times. I can totally understand how easy it is for your fears to escalate. I really hope things go well and it gets easier as the weeks pass. Exploring the cs option might be helpful as international suggests.

international - I was very moved ready about your dream, where the little one that you lost kissed you. Made me quiet emotional here now. Congratulations on your subsequent dd; and the very best of luck with everything if you are planning on conceiving.

Thanks euro. It's so hard to assess future regrets as it's impossible to know what we might be regretting ie baby or loss... Three possible outcomes from now:

Try - baby
Try - loss (potentially late)
Don't try - no loss and no baby.

I could add: try - early loss ; and try - extremely premature or premature baby; as these are also possible outcomes for us; esp. as our little boy arrived at 23 weeks, just one week short of being considered "viable".

Since the last mc I have been firmly in the "don't try" zone, but trying to work out if I could muster the strength to manage anxiety relating to pregnancy and possible future grief. I'm still not sure. though I will definitely explore all the very helpful suggestions here. Yes, I think I will definitely avail of counselling if we do go ahead, I'm just realising that it might be necessary to keep me sane!

I am so grateful for my dd though; she is just wonderful - I am very lucky there. So maybe I should just leave things as they are.. Agh! Sorry for going on.. I think it is helpful to write down though.

International and Tayto

Me and hubby have discussed ELCS and it is something that I think we both want - especially him. The last thing we want is for my heart to give in during labour or I start having seizures etc and something happens to me or the baby. We have got an appointment with a Cardiac Obstetrician in 4 weeks so I will see what he thinks....

Best of luck writer. Maybe we can start a support thread on the pregnancy board if I get pregnant too! I hope everything goes well for you, dh and the new little one. I will look out for your news. X

Thank you Tayto and I hope you and your husband come to a decision that is right for you. If that decision turns out to TTC then I hope you and baby stay safe and well x x

OP: Why on earth were you on aspirin and heparin during pg??? That's pretty risky... I assume the HCPs thought the benefit outweighed the risk, but still, I wouldn't be at all happy about being on those kind of drugs during pg and I'm glad you won't be taking them any more. Will you be having regular scans if you get pg again? I too will be high-risk and have been promised an early scan and then regular visits to the obstetrician.

I thought it was quite common for women to be given blood thinning drugs if they had a history of miscarriage?? Not sure of the reason why though?!

According to google they increase the efficiency of the placenta

raraz aspirin and heparin are commonly used to treat blood clotting disorders in pregnant women - especially following a previous miscarriage. As I have factor v Leiden (a Fairly common blood clotting disorder) I was advised to take both. During pregnancy blood clots more easily, and if you are already predisposed to this it can occasionally cause problems. I seemed to have a blood clot between the placenta and wall of the uterus which could have caused the placenta to break away during the first miscarriage (placenta abruption). I assume aspirin and heparin, both blood thinners, would curtail any clotting. My consultant advised that I would still be advised to take both if I got pregnant again. However I must admit there was a frightening amount of blood when I miscarried while on aspirin and heparin...no way could I have stayed at home!

Scans don't really reassure me - I had my 21 wk scan two weeks before my little boy came at 23 weeks, and my 13 week scan a week before my last miscarriage and both were normal. In both labour/bleeding started suddenly and there was nothing that could be done. I guess scans do provide reassurance though which does help deal with anxiety.

Best of luck with your pregnancy raraz.

Tayto - before ttcing again last year, I met with my consultant to discuss how risky another pregnancy would be. He referred me for counselling and I had just one session to establish a relationship with the counsellor.

I met the counsellor fairly regularly during subsequent pregnancies and post-miscarriage. It has helped massively as I struggled to make a decision on whether to try again and to cope with complications and loss.

I would never have proceeded had I known what would happen so far. But right now I have no regrets.

I see. I guess the problem is that anticoagulants can also increase the risk of MC and, as you sadly found out, make MC more dangerous in terms of blood loss. Tricky one.

OP: Is there anything that you would find reassuring? If there's anything you think would help, I'd encourage you to pester your GP for it. Have you thought about seeing a counsellor or having accupuncture?

Aspirin here to for placental problems. Very standard practice to have half a dose a day while pregnant. It's called baby aspirin.