Holding Hope and Uncertainty With Pregnancy

Source: Erick Gustafson

Two years ago around this time, October 2022, I experienced what is called a “chemical pregnancy,” which is when an egg is fertilized and you receive a positive pregnancy test, but it doesn’t implant in the uterus and a period ensues.

I got pregnant again shortly afterward in December of 2022 with a positive pregnancy test on Christmas Day and, wanting to be hopeful, shared the news with family, even though it was early. I went into 2023 planning for our second child.

Not even a month into 2023, on January 31st, I started bleeding. At that time, I should have been close to 10 weeks pregnant, but when we went in for an ultrasound, I was told they only saw the start of a pregnancy. No baby. No heartbeat. I had experienced a “missed miscarriage” meaning that my pregnancy had stopped progressing but I was unaware up until that point. My hopes and dreams for 2023 died that day.

We spent the next few months trying to get pregnant. In hindsight, it was not that long, but it felt like an eternity. I had another chemical, another positive pregnancy test that disappeared, much like the first. I had all but given up.

Then in June of 2023, my period was late. I took a pregnancy test and it was negative, but my period never came. It turned out that I was pregnant again. And yet, given my experience, I was apprehensive. I no longer wanted to be hopeful. I felt betrayed by hope.

When we went in for the ultrasound this time there was a heartbeat. I was still apprehensive. The next time we went in, I remember saying something to the doctor about wanting to see if there was still something in there. She told me that after you see a heartbeat the risk of miscarriage is very low, about 3 percent, but I still did not feel safe. I never felt safe. Not after the first trimester, not at any point.

Miscarriage Statistics

In many ways, I am surprised at how impacted I was by my miscarriage, particularly because I knew that early pregnancy miscarriages are common, around 20 percent. I also knew that early miscarriages, around 50 percent according to the American College of Obstetricians and Gynecologists (ACOG), are due to chromosomal abnormalities rather than concerns related to fertility. In fact, the rate of recurrent pregnancy loss is rare, around 1 percent according to the ACOG. None of this comforted me.

My relationship to pregnancy was forever changed. It was no longer a straight line. Particularly because I had come to specialize in perinatal mental health and worked with many clients going through their own pregnancy journey, I knew that there is no safe time. Pregnancy loss can occur early, as mine and most pregnancy losses do, but it can also occur in later pregnancy, which, after 20 weeks is considered a stillbirth and occurs 2 percent of the time.

Having had an emergency c-section with my first due to complications with the umbilical cord, I also knew that even a healthy, full-term baby could die due to factors beyond my control. This fact horrified me.

I remember telling my therapist at the time, “I cannot control what happens inside my own body.” I could not control if I did or did not get pregnant. I could not control if my pregnancy progressed or not. It felt like I could not control anything.

I have worked with many clients since who struggle with this same thing, the lack of control they have in their own pregnancy journeys. It can be tremendously difficult.

Acceptance and Commitment Therapy

I approach my work as a psychologist, and my own life, through the lens of acceptance and commitment therapy (ACT), which emphasizes the acceptance of things outside of your control while simultaneously committing to living in alignment with the things that matter most to you.

I speak often with my clients about the limits of control and also about the importance of accepting difficult emotions, even hopelessness, knowing that feelings are feelings, not facts.

Like many of my clients, I have a tendency to cope with things by adopting a hopeless stance. This may seem odd, but many people believe that if they don’t have hope, they can’t be disappointed. My experience, and my clients' experiences, seem to suggest that it doesn’t quite work out that way. It seems that even if you are hopeless about something you can still experience disappointment.

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Loss is just one of the aspects of the human experience there simply is no escaping. But loss is also a reflection of love.

What I encourage people to do instead of adopting a hopeless stance is to simply let go, which it turns out is not so simple. But, the reality is, when you get pregnant and if that pregnancy progresses is simply outside of your control. Not just pregnancy, but life, is uncertain.

Exactly one year from our miscarriage, January 31st, 2024, my rainbow baby arrived. I am incredibly grateful for her. I know that rainbows do not always follow the storm of pregnancy loss.

If you are struggling with pregnancy loss and having trouble maintaining hope, know that you don’t have to. It is OK to feel hopeless. But know that hopelessness is a feeling, not a fact.

Also know, that even if your loss was early like mine, it is OK to grieve. Grief is not measured by how many weeks pregnant you were. In pregnancy loss, as in many other types of loss, it is the loss of the imagined future we must grieve.

And, if you will be lighting a candle on October 15th, 2024, which is Pregnancy and Infant Loss Awareness Day, or remembering your loss in some other way, know my heart is with you.

To find a therapist, visit the Psychology Today Therapy Directory.