Abstract

The death of a baby during pregnancy, birth or in infancy is an intensely traumatic event for the mother and her family. Many women who suffer such loss go on to conceive another baby during this psychologically fragile time when grief and trauma dominate. Although pregnancy after loss may bring hope, it can come with exceptionally high anxiety and distress. Unfortunately, pregnancy after loss, especially if progressed to beyond gestation of previous loss, is not always recognised by health professionals as an acutely vulnerable time for parents. Whilst many caregivers receive training in how to break bad news and support bereaved parents around the time of loss, few receive guidance on how to optimally care for parents during a subsequent pregnancy. There can also be reluctance on the part of health professionals to talk about the baby who died, which means that many families are left to cope with distress in their own time. However, if the psychosocial aspects of the new pregnancy are negotiated with skill and the right support, this period can restore some psychological balance in preparation for the new baby's arrival. This article, written by parents who have experienced pregnancy after loss and caregivers, offers a list of concrete suggestions for psychosocial care based on how trauma and grief impact women and partners in subsequent pregnancies. We propose a set of communication strategies that involve gently acknowledging the loss and anticipating its effects on how the new pregnancy is experienced, as well as organisational strategies that offer an additional safety net. Together, these suggestions have the potential of creating a pregnancy experience that allows for better communication with health professionals as well as the new baby.