For some pregnant women, however, feeling joy is a psychological luxury they can't afford. These are women who after one, sometimes many, miscarriages, stillbirths or newborn deaths, are pregnant again.
To protect themselves from another potential crushing emotional blow, it is easier to think of their pregnancy as an impersonal biological condition. They are not, in fact, "expecting a baby." There are no joyous baby showers. Mainly there is anxiety.
Denise Ct-Arsenault, Ph.D., an associate professor in the University at Buffalo School of Nursing, is one of the few researchers to study the field of pregnancy after perinatal loss. She uses the metaphor "One Foot In -- One Foot Out" to characterize the state of being for these women.
" 'One Foot In -- One Foot Out' describes women's sense that the pregnancy is uncertain, so they steel themselves emotionally by acknowledging that the pregnancy may not end with the birth of a live baby," says Ct-Arsenault. "They cushion themselves against attaching to the new baby.
"For most of these women, carefree enjoyment of a pregnancy is not possible. Instead, it is a balancing act between trying to insure safe passage of the baby while maintaining emotional stability."
A nurse specializing in the care of childbearing families, Ct-Arsenault is the first to develop a pregnancy anxiety scale that can be used to determine if a woman in this situation could benefit from extra emotional support.
"When a woman becomes pregnant after a loss, that pregnancy is a very different experience," says Cote-Arsenault, "but the care she receives isn't necessarily different. These women are in a very different place. Most are emotionally guarded. Many experience high anxiety and stress. There is a loss of innocenc
Contact: Lois Baker
University at Buffalo