Pregnancy After Loss: Conversations for Couples
As a follow-up to my last post on questions to consider individually before trying to conceive a new pregnancy after loss, here is an offering for couples: a framework for conversations to have before trying again.
First: what happened?
When I was learning to treat trauma, one of my teachers used to say, “In order for there to be an after, there has to be a before.” This means that as much as we wish that we could put painful past experiences away and deny that they happened, our bodies and minds won’t believe in a changed present if we don’t acknowledge the traumatic past.
To that end, if you and your partner haven’t spent time together talking about your individual and collective loss and grief experiences, now is the time. Here are some places to start:
Take turns telling the story of your pregnancy/pregnancies. How did you feel about being pregnant, or learning that your partner was pregnant? What was it like to learn that the pregnancy would end? What happened physically to each of you? What happened emotionally in the early days? What happened as time went on? Make sure that the non-birthing partner gets plenty of room to share their experiences.
Talk together about how you view the lost pregnancy now. Some people like to envision the child that never was and to feel a continuing bond; other people want the opposite. You and your partner don’t have to agree, but it is important to understand and respect each other’s views.
Whether or not you both wish to feel a continuing bond, consider a ritual to honor and remember what you went through. This could be a symbolic object or piece of art you choose for your home, a special dinner on the intended due date or the anniversary of the loss, or a candle that you light from time to time.
Consider whether there is lingering anger, disappointment, or other difficult emotions toward your partner after what you have been through. This is natural and these feelings don’t need to go away before getting pregnant again, but they are important to acknowledge internally and perhaps to your partner as well. Consider also where gratitude for and pride in each other exists, and think about expressing it.
Second: how are we doing now?
In line with my last post about readiness for pregnancy after loss, spend some time together thinking about where you each are individually physically and emotionally and where you are as a couple. Here are some questions to talk over:
Do we both feel like we can talk to each other openly about our hopes and fears? What hopes and fears do we each hold in this moment?
What has changed for each of us, and for us as a couple, since the last time we were pregnant? Think about internal and external changes.
As a couple, do we feel sturdy enough to take on not only a new pregnancy but the renewed possibility of adding a baby to our lives? Is this a tolerable time to add a new stressor? What will our lives look like over the next few years if this pregnancy results in a baby?
Are there unaddressed mental health difficulties, problematic substance use, or heightened interpersonal conflicts that we need to work on before the intensity of a new pregnancy?
Third: what will happen next?
You both know that trying to conceive and moving through a pregnancy is unpredictable and challenges our wish to be able to control what happens to us. We can still do some thinking to prepare ourselves and set expectations, though. Consider discussing:
If we are going to use assisted reproductive technology, again or for the first time, do we both understand the process and what it will be like for us? What questions do we have for our doctors? If this isn’t the first time, how did we do emotionally last time and are there changes in how we might support each other that would be helpful?
If we are “trying the old-fashioned way,” how are we feeling about this? How would we like to approach “trying”? How carefully do we want to monitor fertility signs, and in what way? How much do we want to talk about it?
And in either case, how is our romantic and sex life feeling? How can we stay connected to our love through the possibly fraught time of trying to conceive?
If these questions feel too tense, scary, or difficult to talk through on your own, or if you just want an intentional space with a neutral, helpful listener, consider reaching out to a couples therapist experienced with reproductive loss and trauma, like me.
