My work as a specialist medical negligence solicitor at JMW often involves investigating the death of a baby that has happened during pregnancy, birth, or in the newborn period. Each and every case that I investigate is a tragedy in its own right and leaves the child’s family with scars that last a lifetime.

I find one particularly sensitive area for these families is pregnancy following the loss of a baby. The range of emotions felt by parents at this time can be vast and sometimes difficult to navigate. This Baby Loss Awareness Week I posed questions to Dr Hassan Kapadia, a consultant psychiatrist who treats women who have experienced birth trauma, including miscarriage, stillbirth, and neonatal death, about this issue and the advice he has for women who want to be, or are, pregnant following the loss of a child.  

In your experience, what are the main issues that women who’ve previously lost a baby face when becoming pregnant again?

Losing a baby is a traumatic, devastating experience that has a profound emotional, psychological, and physical impact. Every woman and their family will respond very differently. It is very normal for them to feel a mixture of emotions when they become pregnant again, and this can feel confusing and overwhelming. It is also very important to acknowledge that a rainbow baby is not a replacement for the baby who was lost.

Whilst most people would see pregnancy as a time for celebration, women who have lost a baby can experience fear and anxiety. Becoming pregnant may also increase some of the feelings of grief following the previous bereavement, that can make it difficult for the woman to feel joy and happiness. They may struggle with the memories of their previous pregnancy and find it difficult thinking about and preparing for the birth.

Roughly a quarter of women who’ve experienced birth trauma – which includes baby loss – will develop post traumatic stress disorder (PTSD). For these women, the thought of having another baby, being in the delivery suite, or coming into contact with midwives and birthing professionals can lead to intense emotional distress, that requires a level of deep understanding and compassion from friends, family and professionals.

What advice would you give to a woman who wants more children but doesn’t feel this is possible due to the trauma of losing another baby?

Firstly, it is important to recognise that no one will ever fully recover from the loss of their child. However, with the right support and treatment, their distress may subside and, in time, they may feel ready to try for another baby.

For women who are experiencing symptoms of PTSD, there are very effective psychological interventions that can help address the traumatic memories. There are several different types of therapy with a good evidence base for helping people to recover from trauma. There are also a number of specialist practitioners offering different therapies such as trauma-focussed cognitive behaviour therapy (CBT), or eye movement sensitisation and reprocessing (EMDR).

Women may find it helpful to see a psychologist or psychotherapist who specialises in working with parents who’ve experienced baby loss. Within the NHS, there are specialist maternal mental health services for women who have experienced birth trauma. These services have professionals from maternity, reproductive health, and psychological therapy working collaboratively to provide support.

What steps do you recommend women who’ve previously lost a baby take to support their mental health when becoming pregnant again?

Increased social and professional support is one of the key factors in ensuring a mother stays mentally well throughout her pregnancy and the postnatal period. One of the key recommendations from the Government’s ‘Make Birth Better’ report was for ‘continuity of carer’. Continuity of carer means that the woman gets to know the professionals responsible for supporting her through pregnancy, labour, and birth. Having a small team of named people is particularly helpful for women who are worried or frightened of giving birth. Women who’ve lost a baby will also often receive consultant-led care, which can help to relieve their worries.

Peer support can also be a key factor in combatting low mood, anxiety, and isolation. Speaking to other parents who have experienced baby loss can also be incredibly beneficial.

If a woman is experiencing symptoms during pregnancy that feel unmanageable, then I would recommend speaking to her GP as a first port of call. Depending on the location, the GP can make a referral to specialist perinatal mental health services. These are multidisciplinary teams of psychiatrists, psychologists, occupational therapists, mental health nurses and therapists who work together to determine what that woman needs to support her through pregnancy, birth, and the postnatal period.

There are also several excellent charities who provide support to families who have experienced the loss of a baby: Tommy’s and Sands both offer free information and advice via their websites and over the phone.