When the Worst Happens

Ways to cope with unexpected outcomes of pregnancy

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What if something goes wrong?” my husband asked me about 10 weeks before our first child, a boy, was due. “We talk about traveling with him and teaching him to ride a bike, but what if ...”

“We’ll deal with it,” I said, cutting him off. Normally I’m not superstitious, but I didn’t want to jinx anything.

The possibility that something could go wrong had of course crossed my mind at least 100 times. I had enjoyed a textbook pregnancy, though, and was confident that the only thing I needed to worry about was memorizing the relaxation techniques I had learned in childbirth class.

But as I would come to find out, although the majority of pregnancies and deliveries are problem-free, and although expectant parents might do everything right from day one, some pregnancy and childbirth outcomes are beyond our control. Mother Nature is not infallible. Still, there are ways to come to terms with the most devastating pregnancy and delivery scenarios, as the following three situations demonstrate.

Miscarriage: How Knowledge Can Help

Linda Sullivan, 36, a pastry chef instructor in Danville, Calif., knows the heartbreak of miscarriage all too well: She’s had four. The first happened when she was six weeks pregnant. “I was so depressed,” she says. “I kept blaming myself and wondering if I lost the baby because I wasn’t eating right or pushed myself too hard.”

When Sullivan became became pregnant two months later, she was thrilled. Following a normal pregnancy, she gave birth to a healthy daughter. Two years later, she was pregnant again but lost the baby at eight weeks. After a year and a half, Sullivan conceived again, and she had another healthy girl.

After Sullivan had two more miscarriages, her doctor ordered tests, which so far have been inconclusive. Today, Sullivan realizes how lucky she is to have had two normal pregnancies. She uses this knowledge to help cope with her losses. “Intellectually I know miscarriage is nature’s way, or God’s way, of saying that the baby isn’t healthy enough to be born, but it’s still painful,” she says.

Birth Defects: When You Need Genetic Counseling

Jo Ronneberg, a 34-year-old editor from Columbus, Ohio, was ecstatic when she learned she was pregnant. She and her husband had been planning for her pregnancy carefully.

Ronneberg’s first trimester passed without so much as a hiccup. Then at 16 weeks, her physician took a blood sample for a routine alpha-fetoprotein (AFP) screen. Elevated levels of AFP can indicate a neural-tube defect such as spina bifida (a spinal cord deformity); low levels can indicate Down’s syndrome or other chromosomal defects.

The test levels came back slightly elevated. Subsequent ultrasound testing showed that the baby had spina bifida and hydrocephaly (accumulation of fluid in the brain). Ronneberg and her husband sought a second opinion to confirm the diagnosis, as they were advised to do, and were devastated to hear the same news. “As severe as the defects were, I knew I couldn’t bring this baby into the world,” Ronneberg says, “but deciding to terminate the pregnancy was still excruciatingly painful.”

Ending the pregnancy marked only the beginning of Ronneberg’s heartache. “There was guilt and a lot of anger,” she says. “I would see mothers in the supermarket yelling at their kids, and I just wanted to shake them and say, ‘Don’t you know how lucky you are?’”

It took a year, many sessions with a marriage counselor and help from a support group of couples who had been through similar experiences before Ronneberg and her husband were ready to even think about another pregnancy.

This time, before trying to conceive, they sought advice from a genetic counselor. The counselor confirmed that the odds of having a healthy baby were in their favor, since Ronneberg had been taking increased doses of folic acid, and neither she nor her husband had a family history of genetic defects. This gave them the confidence to try again, and today, happily, Ronneberg is pregnant. But like many women, she won’t rest easy until she’s past the 16-week mark.

“I’ve lost my innocence,” she says.

Delivery Complications: The Unexplained Can Happen

I was 32 and in perfect health when I conceived. Aside from a few common complaints, I felt great for the whole nine months.

But suddenly, in the last hours of my pregnancy, everything went to hell. I had been at the hospital for 30 minutes when the labor and delivery

nurses realized my son was in distress. Liam was delivered by emergency Cesarean section — and in cardiorespiratory failure. He was 2 days old before we knew he’d live.

For the first two weeks after my son’s birth, I sat by his bed in the newborn intensive care unit and cried for hours at a time. “I’m so sorry I did this to you,” I would say to him over and over. Even though at least a dozen different doctors and nurses assured me that what happened wasn’t my fault, I blamed myself.

“You won the crap lottery,” a hospital counselor told me. “You have to accept that and move on.” It was only when she went through my medical records with me page by page that I started to accept that our experience really was mere bad luck.

“It’s very hard to accept ‘bad luck’ as an answer,” says Aline Zoldbrod, Ph.D., a psychologist in Lexington, Mass., who specializes in women’s reproductive issues. “That means you have to admit that the world is a threatening and scary place.

“The intellectual way to cope is to gather information,” Zoldbrod adds. Sometimes you have to exhaust every resource — friends, family, clergy, counselors and physicians — to find the emotional support you need. You also have to be prepared for the possibility that there are no answers.

Liam was almost a month old when he finally came home, but it was another month before I stopped grieving and looking for someone to blame. The day my son smiled at me for the first time, I cried with happiness and finally just let the pain go.

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