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can’t, of course, but the appearance of pregnancy, coupled with the romanticized version of gestation often shown in media—be it television shows, movies, or social media—makes it far too easy for so many of us to deduce a person’s reproductive journey by focusing solely on the end result. You are pregnant, therefore trying to conceive must have been easy for you. You have a baby, therefore pregnancy must have been easy for you.

From the outside, sure, it undoubtedly looked like I had everything back the way I wanted it; yet on the inside, I felt anything but steady. If we know the statistics, then it’s actually safer to assume that the women walking by you whose bellies prompt an oozing of envy have stories of adversity all their own. Struggle is universal—manifesting in different arenas for all of us. We don’t know what anyone else has been through, until we do. And even if my reproductive timeline looked enviable, pregnancy this time around felt like tightrope walking; there was nothing blissful or easy about it. It was rife with charged emotion that spanned both ends of the spectrum. I was grateful—elated, even—but no ounce of my joy was enough to counter the anxiety and fear I shouldered. It seemed as though my feelings would change by the hour; I felt petrified, hopeful, distant, excited, enigmatic … I don’t know that there was a feeling I didn’t have over the course of a single day.

My ob-gyn assured me that I’d likely find some respite after hitting the sixteen-week mark; but as that milestone came and went, it only offered a modicum of the equanimity I was so desperate for. I spent the first four months terrified that I’d lose the baby at any given moment; and even though an element of my fear eventually softened, I spent the remaining five months of my pregnancy walking on eggshells, expecting at each trip to the bathroom to see blood when I wiped. Even in spite of having received news that the fetal chromosomes were healthy, I couldn’t shake the unmistakable fear that something could go wrong at any time.

With my patients’ stories lodged in my psyche, I was all too cognizant of the fact that I was not immune to a repeat trauma. After joining that one-in-four pool, I somehow felt like any of the other horrendous reproductive statistical outcomes were somehow more likely to reach this pregnancy. It wasn’t necessarily a helpful or productive way to think about conception after loss, I know, but a grieving mind has a way of meandering into dark corners—especially given the amount of anxiety that a postmiscarriage pregnancy can usher in. Beyond anything else, pregnancy after loss for me became a lesson—albeit one I wish I hadn’t had to endure—in being present; to do nothing more than inhale, exhale, repeat. It was all I could do to keep from being swallowed whole by anxiety.

This practice of staying present was never more riddled than it was in the moments when I was home with my son. I was stuck in a perpetual state of worry, unable to untether myself from the overwhelming concern that my grief-shredded state of mind might color his childhood experiences. I’d find myself all too aware of my less-patient reactions to things that previously didn’t push my buttons, things that all toddlers are wont to do. I felt like I could actually see myself in real time as I stretched to muster my previous ability to parent calmly. The trauma reared its ugly head in inopportune moments (not that there is ever an ideal time to be thrust back into this kind of havoc) and sometimes overtook my parenting strategies; I watched helplessly as that hallmark irritability rose in me. It felt, at least to me, like it was splintering some of our precious moments together, and I was so hard on myself about every time I thought I hadn’t reacted the way I should have. The way my previous, pre-loss self most definitely would have.

This is the post-traumatic experience—our past remains ever present. Encumbered by the weight of our traumas, we feel the sting of every terrifying possibility. Worrying that my relationship with my son would be affected, worrying that something would go wrong with my pregnancy. Worrying. Constantly. Anything could happen, we think to ourselves. So why should we believe for a moment that the worst-case scenario won’t? The naivete that perhaps existed for us in the past is long gone, replaced by an acute awareness of the risks and dangers that may or may not be dotting our paths, just out of our lines of sight.

Having experienced a miscarriage did not fortify me from having to face whatever horror the other shoe dropping could, or would, bring. I felt just as susceptible to any other type of loss, as though a new iteration of that familiar nightmare might be lurking around any corner. Day in and day out, I felt acutely aware of all the ways in which this pregnancy was so antithetical to the others: fraught with fear. So, seeing the effects of my two back-to-back pregnancies as they rippled through some of my sessions with patients was hard. I didn’t want my personal life—my obvious and protruding maternal trajectory—to in any way affect my patients, of course, let alone hurt them outright. But in sessions like that of Madison’s, perhaps I (or more specifically, my growing belly) inadvertently did. My conspicuous desire to try again—to attempt to grow my family once more—became a focal point for some, and stirred feelings deserving of my pointed attention.

• • •

Even though I’m in support of women sharing their pregnancy news whenever they feel ready, there is a nuance to sharing about pregnancy early on—and particularly so for me, in my role as a psychologist specializing in reproductive and maternal mental health. I’m distinctly aware of how sensitive I must be in considering my patients’ histories. No matter how delicately I shared

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