Pregnancy After Loss: What to Include in Your Birth Plan
When you’re pregnant after a loss, making a birth plan can feel complicated. There’s the practical stuff, of course: where you want to give birth, who you want with you, how you might want to manage pain, and what you’d like your care team to know. But after loss, there can be so much more personal history underneath those decisions. You may be excited to meet your baby and still feel scared about trusting that everything will be okay. You may want to plan for every possibility, and also feel like you don’t want to get your hopes up. You may know what you want ahead of time, or you may not know until the moment comes. Your birth plan can make room for all of that.
Here are some things you might want to include.
1. Where you want to give birth
The place you give birth can shape how you feel throughout the experience. A hospital may feel reassuring because you know you’ll have access to medical care if you need it. But for some people, the hospital also brings up difficult memories. A birth center or home birth may feel more comfortable. There isn’t one right choice. What matters is finding a place where you feel safe and supported.
2. Who you want with you
You get to be thoughtful about who is around you. Maybe that’s your partner and a doula. Maybe it’s a small circle of people who know your story. Maybe you want to limit visitors and even certain hospital staff during labor and after the birth. You can choose the people who will understand the significance of this experience and treat it with care.
3. A doula who understands pregnancy after loss as a support person
A doula who has experience supporting families after loss can offer trauma and grief informed care for both you and your partner. You don’t have to explain why a particular milestone is hard or why you’re feeling anxious even though everything looks okay. They understand that you can be deeply excited about this baby while still remembering what happened before, and will advocate for your wishes.
4. What you want your care team to know about your loss
You shouldn’t have to tell your story over and over again. Ask your provider to make sure your loss is documented in your chart and that the people caring for you know your history. If you’ll be seeing different providers or nurses, having that information already there can make a real difference. You deserve to walk into the room without having to explain why this birth may feel different for you.
5. Name the things that may be hard
There may be certain triggers - words, procedures, sounds, or moments - that bring you right back to your loss. Maybe it’s hearing someone say, “This time everything looks great.” Maybe it’s a particular procedure. Maybe it’s silence during monitoring. Maybe it’s hearing the time your baby was born. Maybe it’s having this baby referred to as ‘your first.’ If you know what some of those things are, you can share them with your care team ahead of time. They may be able to approach those moments with more thoughtfulness.
6. Talk about how you want to receive information
Some people feel better with frequent updates and reassurance. Others feel more anxious when they hear every number or change. You can talk with your care team about what helps you feel informed without feeling like you’re on high alert. This can be especially helpful if something unexpected comes up. Knowing who will explain what’s happening and how information will be shared can give you something to hold onto when plans change.
7. Create a way to honor the baby you lost
If it feels important, you can honor the baby you lost during your birth. You might want to wear a piece of jewelry, bring a keepsake, have a photo nearby, light a candle when you get home, or create another small ritual that feels meaningful to you. There’s no right way to do this. And you don’t have to do anything at all. But if it feels important to you, there is room for your previous baby in your birth story.
8. Have a plan for the unexpected
Birth rarely follows a perfect script. After a loss, an unexpected change can carry a lot more emotional weight. Having some conversations ahead of time can make those moments feel a little less unfamiliar. Who do you want to explain what’s happening? Who do you want beside you? Do you want a moment to take in information before making a decision when there is time to do so? These conversations don’t mean you’re expecting something to go wrong. They’re simply a way of making sure your support people know how to be there if things change.
9. Think about those first moments with your baby
Meeting your baby after a loss can bring feelings you’ve been waiting for, hoping for, and maybe even afraid to imagine. You may want to hold them right away. You may need a quiet moment to take it all in. You may want your partner close, someone to take photos, or no camera at all. You may want to tell your baby about the sibling who came before them. Talking about these things beforehand can help the people around you know how to honor the moment when it comes.
10. Make a plan for after the birth
Your birth plan doesn’t have to end when your baby is born. You can include when you want to announce the birth, what kind of postpartum support you’d like, and who you can call to share your birth story with when you get home.
A birth plan after loss isn’t about trying to control every part of the experience. It’s about giving yourself and the people around you a better understanding of what you may need. There is room for the medical plan. There is room for the emotional plan. And there is room for the baby you lost, too.
