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If you've been through a high-risk pregnancy, just thinking about getting pregnant again can be scary. But many women have high-risk pregnancies.
Will you have another high-risk pregnancy?
It's natural to be afraid that what went wrong the previous time – or several times – could go wrong again.
Meredith Langston* certainly felt that way. She had a miscarriage, an ectopic pregnancy, and a third pregnancy with preeclampsia resulting in twins born at 21 weeks.
The twins did not survive, and she could have died along with them. "My husband could have lost all three of us that day. We had a lot of fears about getting pregnant again," she says
She was also afraid that she was too old to have a healthy pregnancy. She was 39 with the twins, who were conceived via fertility treatments. She worried that she would never have children. "I was afraid of more miscarriages, more losses," Langston said.
Learning everything she could about preeclampsia and weighing the relative risks of another pregnancy helped her decide to try again. And nine months later, she conceived naturally.
Getting through that pregnancy, which resulted in a healthy baby girl, took a great deal of work, worry, and patience. She had to spend the last three months of her pregnancy living alone, without her husband, near a university hospital with a state-of-the-art neonatal intensive care unit.
"I realized my chances of dying from preeclampsia were lower than dying from a car accident. If I can get in a car every day then I can get in a pregnancy. It was a gamble to take the risk to be pregnant again, but I could have a huge blessing out of that risk."
Common fears about getting pregnant again
Berkeley, California, psychotherapist Gina Hassan says it helps for women – and their partners – to talk about being afraid of having another pregnancy. "The fear might not go away, but their relationship to it might change," Hassan says. In other words, talking through your fears may give them less power.
Unresolved grief about previous losses can lead to fear, Hassan says. That includes being afraid to get attached to the life inside you because being too committed could lead to heartbreak. She says this is one of many types of "magical thinking."
"Not attaching isn't an insurance policy against something going wrong," she says. "The truth is that it's out of our control. We can cause ourselves suffering by worrying about what might happen, and that's probably not helpful."
Post-traumatic stress after high-risk pregnancy
Beyond generalized fear, some women develop post-traumatic stress disorder (PTSD) after a high-risk pregnancy, says Anna Glezer, a psychiatrist at University of California San Francisco Medical Center who specializes in perinatal and postpartum issues. PTSD can result from a difficult labor experience as well as from losing a baby or having a traumatic pregnancy.
Glezer estimates that from 1 to 9 percent of women have PTSD after childbirth. They may re-experience the birth in nightmares, become anxious or easily startled, or avoid a postpartum doctor visit because it's in the same hospital that the trauma occurred in.
Hassan has also seen PTSD symptoms in clients who had high-risk pregnancies. "The whole idea of getting pregnant again can be very anxiety-provoking and can be a trigger for PTSD-like symptoms," she says.
She has counseled women who can't face going back to the same ultrasound facility because that's where doctors couldn't find a fetal heartbeat. A woman may switch doctors, even though she likes her doctor, because that's the doctor who gave her the bad news.
Women with pronounced fears or PTSD symptoms shouldn't try to go it alone, Glezer says. They can consider seeing a psychiatrist (possibly one who specializes in "reproductive psychiatry") or a therapist trained in reproductive issues.
Many areas have support groups, and you can easily find online groups for women who have had high-risk pregnancies. Glezer adds that there are medications that can help, and some can even be taken during pregnancy.
Deciding to try again
Pamela Wright* had already given birth to a healthy boy, so her doctors had no cause for concern about her second pregnancy. But then her water broke at 18 weeks. Wright was so traumatized she couldn't talk about it for months. "The loss hit me really hard," she says.
Eventually, though, she started attending meetings that she describes as "amazing" for women who had lost babies late in pregnancy. Talking to others who'd had losses but later delivered healthy babies helped her decide to try again, and she was pregnant within a few months.
Her doctors wanted her to wait longer, but she was focused on having another child close to her son in age. "The doctors were more concerned about me being physically and emotionally ready than I was," she says.
Having another baby, at last
Wright made it past 34 weeks, but she had some scary times. At 23 weeks she was put on bedrest for seven weeks. She was terrified that she would relive her experience with the previous pregnancy, but she knew that if she made it to 28 weeks, her baby would have a much better chance of survival.
On hospital bedrest, she did two things to keep herself calm: She stayed away from her computer to keep from finding information that would only scare her, and she taught herself to crochet. Soon she was making newborn hats for the girl she was expecting and scarves for her son.
"That helped keep me sane," she says. "Whenever I would start to get emotional I would think that already my outcome was so much better than when I had my loss. I thought if I could hang in there, I would be able to take this baby home."
* Her name was changed for this article