Having a Baby After Stillbirth

How to manage the complicated emotions of this "happy" time

by Tara Shafer

My second son was stillborn in 2005. When I found myself pregnant again the following year, I wanted the baby more than I can describe. Still, for the duration of the pregnancy, I felt as though I was coming undone. As though my emotions and thoughts were splintering. 

As I tried to process fear, joy, guilt, and hope all at once, I pictured beads of mercury breaking apart and careening madly away from one another. I went into survival mode – an involuntary reaction and also a mercy.

I have a history of depression. And thanks to my compassionate and expert therapist, I knew that I experienced a trauma when my baby died. I also knew that I would need additional professional support during this pregnancy, so I found an ob-gyn who was also a psychiatrist with expertise in maternal mental health and loss.

With them, I worked through a lot of my grief over the course of this new pregnancy. I wrote. I built support networks. I tried to do things that would ease my anxiety. I also took steps to understand how this pregnancy could be medically differently than my last. I knew that my loss was caused by a blood clotting disorder that could be treated with anticoagulants. In this sense, I was "lucky" because we identified a treatable cause.

Nevertheless, when my son was born I was completely unprepared for my emotional collapse. In retrospect, it happened in slow motion. My fear that something could happen to him was entirely out of proportion to the likelihood that it would. I am not someone who cries easily, but in my hospital bed I wept openly and jaggedly. These were not cathartic tears. They were full of despair and confusion. Nothing about them felt good.

As I held my son, I was full of love and wonder for him. But I was also full of other things – traumatic flashbacks and a feeling of disassociation from reality. I loved this baby with my whole soul. But loving his sweet dewy body quivering with life felt traumatic to me. I was petrified that harm would come to him. I had trouble trusting that he was healthy. I thought I would lose him too.

Weeks and months went by after I left the hospital, and although some of these symptoms eased a bit, others developed. When my son got a fever and was nearly admitted to the hospital as a precaution, I remember being on the verge of hysteria. I would tell anyone who would listen about how his brother had died. Doctors seemed to think I didn't understand what precaution meant. But in that moment, I didn't – not in any meaningful way.

In the months after his birth, I was surrounded by so much love and joy from those who had accompanied me through my previous loss. They were so relieved for me. My throat still tightens at their kindnesses and generous acts. But it was precisely the multiple affirmations of happiness and joy that made it harder for me to recognize that what I was experiencing was the beginning of postpartum depression and post-traumatic stress.

I wish now that I had been able to allow myself to feel the full range of emotions that often accompany the live birth of child born subsequent to stillbirth. In this universe, there is joy and there is gratitude. There is also the anxious fear that all the things you love will vanish, as well as the sadness of what is actually lost (a baby, a mother's sense of identity). The things we do not permit ourselves to say or feel yearn to be expressed. If we neglect them, it's easy to start neglecting ourselves.

My sleeping habits – which were never great – grew worse. I had a newborn, so on the one hand this seemed reasonable. But it was really a way to punish myself. To make me feel just a little unhinged by flirting with the edges of what felt manageable.

I also did not eat well. I ate enough to keep up my milk supply but started to drift a bit toward body image issues I thought I had long since conquered. I stopped showering as often. I did all these things even as I fooled myself and everyone around me that this was normal for any postpartum woman. But I was not "any" postpartum woman. My issues about death and life were multi-faceted and all mixed up.

It took me years to understand that I was suffering from postpartum depression. I white-knuckled it, but I wish I hadn't. I wish I had sought professional help for myself, and I want other mothers in my shoes to know that they can benefit from it. 

I hope other women who have given birth to a healthy child following a loss give themselves permission to feel every last feeling they have and know when these feelings move from a normal response to loss into depression or post-traumatic stress.

And for these women I have written a brief guide to managing the emotions of giving birth after you have experienced a stillbirth. My wish for them is to get the support they need and deserve.

Know that it’s completely normal to experience emotions other than joy. According to Christiane Manzella, clinical director of the Seleni Institute and a specialist in helping women move through grief, it is not unusual for moms who have a healthy baby after a stillbirth to have thoughts such as "Did I make a mistake?" or "I don't like this baby," or "I can't keep my baby safe."

Consider seeking professional help. "You do not have to find your way alone,” advises Manzella. “There is strength in being vulnerable." I recommend talking to a therapist even if you are not especially aware of a specific need or benefit. You have experienced a great loss in a culture that both denies death and emphasizes that everything about have a baby is meant to be happy. This can be a toxic brew and speaking with someone trained in grief support can bring you incredible relief.

Be aware of the signs that you should contact a mental health professional. Dr. Manzella emphasizes that that you should definitely talk with a mental professional if you:

  • Feel despair.
  • Are confused by or ashamed to admit your feelings.
  • Become increasingly distressed and anxious about your ability to take care of your baby (as well as maintain your own safety and well-being).
  • Find your thoughts so intrusive and distressing that you are doing anything you can to avoid them.
  • Feel helpless and believe that you cannot cope.
  • Dread sleep because of the images or dreams you experience.

Know that it’s normal for grief to remain with you, but it will become easier to bear. It is natural for mothers who lose children to spend a lifetime mourning this loss. But the healthy integration of grief will scaffold and support the life you build with your living children, even as you remember your loss.

If you need help after losing a baby, here are resources: 

Reconceiving Loss (This is the organization I founded after losing my baby.)
Mommy Interrupted
Pregnancy After Loss Support
Return to Zero Center for Healing

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Tara Shafer

Tara Shafer

Tara Shafer is co-founder of Reconceiving Loss, an online resource center to support families coping with pregnancy and infant loss. She is a contributing blogger for Psychology Today, BabyCenter, the Huffington Post and Still Standing. Her work has appeared in the New York Times and on National Public Radio. Tara has been an international human rights and refugee advocate and holds a Master's degree from Columbia University.