Babyloss and Anxiety | Counseling | Therapy

Babyloss and Anxiety

Dr. Erica , LCSW, DSW — Therapist

Even if you have always believed yourself to be psychologically healthy, the experience of babyloss can challenge how you view yourself, others, and the world. Of course, it's not uncommon for first-time moms to experience anxiety at the beginning of a pregnancy, especially during the "danger zone" of the first trimester when a loss feels (and sometimes, for women who have experienced multiple miscarriages, is) more likely. During this time, I know many women who have avoided telling anybody that they are pregnant.

Unfortunately, the experience of miscarriage is not uncommon, and if we have not experienced one ourselves, we may know stories of women who have experienced this heartbreaking form of early loss. As a result, pregnant women may look for the warning signs: cramping, bleeding, and other symptoms that might be a clue as to whether they are experiencing a miscarriage. However, there are also many non-lethal conditions that may cause bleeding, and certainly, cramping, aches, and pain, can also be completely normal in the first trimester. No matter how frightening the first trimester can be, a pregnant woman may often experience a sense of relief once they reach 14 weeks.

The challenge, of course, is that sometimes pregnancies still end after the first trimester is complete, and these experiences may bring about much more anxiety approaching future attempts to conceive and subsequent pregnancies. Women that end wanted pregnancies or experience still birth may experience symptoms that look very much like anxiety and panic attacks when they consider trying again. In fact, they may even have flashbacks visiting the OB's office, and have feelings of impending doom when they show up for their ultrasounds. Some women may even avoid trying to conceive again because they feel they are "marked" for deadly diagnoses, and that they will never be able to achieve healthy pregnancies. It's always important to follow up with your physicians and any reproductive health specialists that can give you the most accurate medical information about your own personal risk factors when it comes to having a baby, but there are also ways of lowering those odds in the case of future fetal anomalies (a quick example: getting screened for the MTHFR mutation and taking higher doses of folic acid in the case of neural tube defects), and for women who appear not to be carriers of defects and have experienced "bad luck" of random anomaly, cord injury, or otherwise unexplained stillbirth, sometimes magical thinking about these experiences can cloud the reality of the next pregnancy.

Anxiety is useful in certain circumstances: being apprehensive about potential dangers helps us to mitigate them and protect ourselves, provided that danger is real. Here's the challenge with anxiety: it's often based on feelings, not facts, and "anxiety brain" can fool us into assuming that we are always primed for the worst outcomes in life, particularly when we have experienced the heartbreaking loss of a pregnancy. Sometimes, it feels easier to avoid triggering situations than face them, but in the case of anxiety, challenging and exposing yourself to it is the most helpful thing you can do.

It seems counter-intuitive, but avoiding talking about whether your next baby will have a birth defect or not, telling yourself that you will receive bad news about your upcoming ultrasound, or not making those early appointments will only cause your anxiety to grow. A simple mantra that is useful in the case of anxiety is don't always believe what you think. When anxiety circles around inside of our heads, we avoid confronting reality and choose to engage with and ultimately believe it. Unfortunately, the world does not run according to your anxiety's logic. Just imagine: if being afraid of something caused it to happen, nobody would survive, and our world would look quite different!

So, what helps when you're experiencing understandable anxiety as a result of babyloss?

1. Exposure. Believe it or not, walking through your fears can be helpful. Usually in the presence of a trusted therapist, you might imagine an anxiety-provoking event first, or write about it, accounting for your overall level of distress. A seasoned therapist will help you face fears that are not causing you major distress first, so that you can start with something low-stakes. An example for a woman who is afraid to go to the doctor might be the process that involves walking to the door of the medical building and sitting in the lobby, when she is ready. With her therapist, she can first imagine this situation, and practice relaxation techniques such as deep breathing, as well as challenging her anxiety and other useful techniques. When she feels ready, she may attempt to do this in real life, allowing herself to experience distress, but also practicing the tools that manage it, until she feels she can make the medical appointment.

2. Challenging the anxiety "bully". Picture a bully in your life, from your childhood, or from popular media. Imagine that your anxiety takes the form of that bully, and fight back! Bullies love nothing more than gaining power over their victims, so consider that by succumbing to the bully, you're allowing your anxiety to control you. Instead, challenge that bully! Fight back with statements such as "You're just a bad thought and bad thoughts can't harm me"; "I am stronger than my anxiety"; and other phrases that you and your therapist create together to allow you to feel a sense of power. Some clients feel that even engaging in martial arts or kickboxing classes can be helpful as they envision beating the anxiety bully down!

3. Move the focus away from your brain. I find Yoga Nidra meditations, in which you engage in a guided rotation of consciousness, to be very helpful in the experience of babyloss. Some of my clients have felt prisoner to their anxiety as they follow it in circles around their head. So, in addition to freeing these thoughts from inside through journaling and talking through them in therapy, they have found Yoga Nidra meditations to be helpful. Yoga Nidra does not involve assuming physical yogic postures. Rather, it is a process of moving one's focus from the mind to the experience of being in the body, from the tips of the fingers to the toes. Yoga nidra also involves a practice of setting a positive intention, creating gratitude, and envisioning achieving that intention. It can be a very helpful space to create for yourself, and there are many recordings available on iTunes to choose from.

It's truly essential to work with a therapist when it comes to managing anxiety after babyloss. A good therapist can help normalize this experience for you, because it is normal, but that doesn't make it very hard. I know it can feel frightening to talk about your fears, because you may be afraid to "put them out into the universe", but in fact, the opposite is true. Having a safe space to explore and challenge your anxiety often helps you feel better, and does not invite bad luck into your life.

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