Pregnancy Loss and PMADs
TL, DR
Pregnancy loss, whether early or late, is a profound emotional trauma that increases the risk of Perinatal Mood and Anxiety Disorders (PMADs).
Grief from loss doesn’t just vanish; it lingers and can affect your mental health, relationships, and future pregnancies.
Seeking emotional support through therapy, support groups, or trusted friends is crucial for healing.
Understanding the signs of PMADs and tracking your mood helps you address mental health concerns early.
Self-care, setting boundaries, and giving yourself time to heal are essential in managing both grief and potential PMADs.
I still remember it like it was yesterday.
It was 17 years ago. I was 22 weeks and 2 days pregnant with my first baby. The first time I experienced something so traumatic it would change the course of my life forever.
I had pPROM—preterm premature rupture of membranes. My water had broken due to undiagnosed bacterial vaginosis (BV). The next day, at 5:00 p.m., my baby was born. Just a handful of minutes later, he was gone.
The grief was suffocating.
For what felt like an eternity, each morning I'd wake up, and for a split second, I would forget. Then, just like that, I would remember all over again.
There is no healing from a loss like this. You get through it, but you never get over it.
Pregnancy loss, whether it's at 10 weeks, 22 weeks, or 40 weeks, means saying goodbye to a baby you already love. It's the loss of the hopes and dreams you had for your future, and coming to terms with the fact that your future no longer includes that baby.
It leaves emotional scars that will affect you, your relationships, and your future children for a lifetime. It will affect your next pregnancy, your next birth, your next postpartum, and your parenting style.
And unfortunately, it puts you at a higher risk for perinatal mood and anxiety disorders (PMADs).
It feels infuriatingly unfair. You’ve already suffered a devastating loss, and it’s like, "Goddamn, Universe, just give me something here. Give me an easy pregnancy. Give me the beautiful, blissful birth I want. Give me an easy postpartum."
But sadly, the Universe has its lessons, and sometimes, those lessons involve more loss, fear, and anxiety. It’s not something we talk about enough in our culture. We live in a world of happy endings, and no one wants to talk about pregnancy loss, miscarriage, infant loss, or stillbirth.
But it's real. It’s painful. It’s common. And we need to talk about it.
The Aftermath
When I lost my baby, I thought the worst was over. I thought that once I got through this and healed physically, then, I could start to heal emotionally. But that’s not how it works.
The emotional devastation of pregnancy loss is heavy enough on its own. But what we don’t talk about is the impact on your mental health. On top of the grief, the trauma of losing a pregnancy comes with guilt, shame, anger, confusion, and isolation. There’s the haunting “what-ifs” and “I should haves” and the pressure to grieve in a way that’s considered “acceptable.” You want to – NEED TO – honor your baby’s memory, but you’re not always given the space to do so.
That’s when the risk of PMADs can begin to take hold.
Why Pregnancy Loss Increases Your Risk for PMADs
Pregnancy loss is a “Big T- trauma.” And just like any trauma, it can take a toll on your mental health.
PMADs (Perinatal Mood and Anxiety Disorders) can show up in various forms, such as depression, anxiety, panic attacks, OCD, PTSD, bipolar disorder, and postpartum psychosis. They can develop at any point during pregnancy or up to a year postpartum. During pregnancy, your body is adjusting to hormonal shifts, and after birth, your body is recovering. Meanwhile, your mind is struggling to find balance, and the emotional turmoil can feel overwhelming.
The grief lingers. It changes the way you interact with your own body, how much trust you have in it, and how much trust you have in the future. It can make everything you once understood feel completely upside down, and It can leave you wrestling with fear and uncertainty, trying to enjoy your current pregnancy without being consumed by what might happen.
I’m Not Alone—And Neither Are You
What I’ve learned through my own experience—and the experiences of so many other loss moms—is that pregnancy loss is not something you “get over.” It takes time, care, and a real understanding of what your body and mind need to heal.
The truth is, we do not talk enough about the mental health impact of pregnancy loss, especially in the context of PMADs. It’s hard to know that we are at an increased risk, especially when you’re still so deep in the grief. But knowing that PMADs are a real possibility means that we can prepare ourselves, get the support we need, and take steps toward healing.
What You Can Do
If you’ve experienced pregnancy loss, please know that all of your feelings are valid – yes, even the ones you feel when you see another pregnant mom, or when your bestie announces her pregnancy and you can’t seem to find it in yourself to be happy for her. Yes, even then, your feelings are valid. Your grief is valid. The anger, sadness, and confusion you’re feeling are real.
Here are a few steps to consider for your healing:
Get Support
Find folks who can provide emotional support during this emotional rollercoaster of a time. This might mean reaching out for professional help, joining a group, or simply leaning on a trusted friend or family member. Here are some actionable tips:
Therapy: Consider finding a therapist who specializes in grief or perinatal loss. Therapy offers a safe space to express your emotions and navigate complex feelings. You can find PSI-certified therapists through Postpartum Support International here: [link].
Support Groups: Join a support group to connect with others who are experiencing similar emotions. If you’re local to South Jersey, the Hoping Unite (Infant Loss) Support Group run by Ann Coyle was invaluable to me. It’s a wonderful way to be with others who get it.
Talk to a Friend: If professional groups aren’t your thing, don’t hesitate to reach out to a close friend. Unfortunately, you might find that some of your friends have experienced loss themselves. Let them know you need emotional support, even if it’s just someone to listen—without offering advice. When I was going through it, I created a list of things I didn’t want people to say to me about my loss and shared it with my friends via email. They told me how much they appreciated it. Here’s a list for you to share with your friends.
Online Communities: If you can’t find a local support group, there are many online communities (such as Facebook groups, Reddit forums, etc.) where you can connect with others who understand what you’re going through.
Recognize the Signs of PMADs
Being aware of how grief and hormonal changes might affect your mental health is key to healing. If you're struggling with anxiety, depression, or other symptoms, it’s important to get help. Some actionable steps you can take:
Track Your Mood: Keep a daily journal to track your emotions and symptoms. This can help you identify any patterns or shifts in your mental health, making it easier to address early on. Here’s an editable template you can use.
Set Boundaries: Don’t push yourself too hard. Set limits on what you can handle each day and give yourself permission to say no to things that feel overwhelming. If you struggle with setting boundaries, I highly recommend the book Boundary Boss by Terri Cole. It’s packed with practical strategies to help you take control of your boundaries and protect your emotional well-being.
Talk to Your Doctor: If you're experiencing symptoms like intense sadness, irritability, or anxiety, it’s important to talk to your doctor or a mental health professional. They can help assess if you’re dealing with PMADs and provide treatment options. Just make sure that whoever you work with specializes in perinatal care. As a certified perinatal mental health professional through Postpartum Support International (PSI), I’ve dedicated my practice to supporting moms like you. You can find a list of certified professionals here.
Practice Mindfulness:
Mindfulness techniques, like meditation or deep breathing exercises, can help manage anxiety and stress, especially when you're dealing with the emotional intensity of pregnancy loss or postpartum challenges. These practices help bring you back to the present moment, grounding you when your mind feels overwhelmed with what-ifs and difficult emotions. Even just five minutes a day of focused breathing or a short meditation session can help you feel more centered and calm.
One great resource for beginners is the Insight Timer app for mindfulness and meditation. It has a huge library of guided meditations, breathing exercises, and mindfulness practices that are completely free to use. You can search by specific needs, like anxiety, grief, or sleep, and there are tons of resources to help you get started. It also includes a timer feature if you prefer to meditate on your own.
Take Care of Your Body
Physical recovery after a pregnancy loss can be a long and difficult journey. Your body deserves love and care during this time. Here are some practical tips:
Rest: Prioritize sleep and rest. Your body needs time to heal, and rest is imperative for both physical and emotional recovery.
Eat Nourishing Foods: Focus on eating nutritious, whole foods that support your body’s recovery. Incorporate plenty of fruits, vegetables, and proteins that will help replenish your energy.
Gentle Movement: If you’re physically able, try gentle movements like stretching, yoga, or light walking to help your body regain strength. Start slow and listen to your body’s needs.
Hydrate: Drink plenty of water throughout the day. Staying hydrated helps your body heal and maintain energy levels.
Give Yourself Time
Healing is a slow, sometimes nonlinear process. Here’s how you can support yourself through this:
Set Goals: Focus on small, realistic goals for your day-to-day life. It could be as simple as taking a shower, eating a meal, or getting outside for a short walk.
Be Kind to Yourself: When negative thoughts creep in, practice self-compassion. Remind yourself that it’s okay to not have everything figured out. Healing takes time, and your feelings are valid.
Create a Routine: A routine can provide comfort and stability when things feel uncertain. Start with small, manageable activities like making your bed, taking time at red lights to breathe, or meal planning can help you begin to feel in control again.
Don’t Rush It: Grief has no timeline. There is no “right” way to grieve, and you will heal at your own pace. It’s okay if it feels like you’re not making progress or if some days feel harder than others.
Loss can be isolating, and grief can make you feel like no one else understands your pain. But you are not alone. And you don’t have to heal alone.
For Neurodivergent Moms:
If you're neurodivergent and find that your grief process feels different or more challenging because of the way you experience the world, be sure to check out [this post](link to the other post) for additional strategies and resources tailored to your unique needs.
If you’ve experienced pregnancy loss and are struggling with your mental health, I’m here for you. Please reach out to talk, share, or ask for support. Healing is possible, and you don’t have to go through it alone. Book your free call here. 💜
