I was responsible for what happened to my baby.

My body failed my baby; I failed my baby.

Now that I'm pregnant again, I should be bonding with this baby, but I can't. It will damage my baby.

I should feel grateful to have a healthy baby after loss, but I feel resentful. I am a bad mother.

My grief is taking me away from my friendships. I am a bad friend. 

After Loss, Guilt Everywhere

Have you ever felt guilty after losing a pregnancy? You should know that you aren't alone. In fact, research on mothers' feelings of guilt after stillbirth, miscarriage, or other forms of babyloss has identified that self-blame is extremely common. As Gold, Sen, and Leon (2018) note, "After [babyloss]...parents commonly struggle with questions about whether their own actions, behaviors, thoughts, or omissions could have contributed to the death of their child" (p.41). While guilt can be painful and overwhelming, Gold et al. (2018) note that blaming oneself for babyloss does serve a psychological purpose, as it provides parents with a sense of meaning or control over events that often feel random or do not make sense. If parents can find reasons within themselves for what happened, then, perhaps, they can control the outcome of future pregnancies:

Next time I'll rest more. 

I'll be sure to ask for an earlier scan so that I'll know that something is wrong sooner, and there will be more options for us. 

When grieving parents resolve to change their behavior and increase the likelihood of a healthy pregnancy, they may forget that, unfortunately, there are not always clear-cut solutions for why pregnancy loss happens, or why certain pregnancies are affected by devastating anomalies. Certainly, advances in genetic and prenatal testing can help inform expectant parents about risks and options, but pregnancy can be full of uncertainty. Guilt and self-blame can lock babyloss parents into a cycle of self-loathing, depression, and isolation, and it can affect how parents-especially mothers-evaluate themselves in future pregnancies and parenting experiences. It is not uncommon for guilt to affect a mother's sense of self as she encounters the new terrain of a potentially healthy pregnancy, the birth of a rainbow baby, and raising a child. 

Society places so many expectations on expectant mothers, prescribing organic, natural diets, breastfeeding, medication-unassisted laboring, skin-to-skin bonding, and the ability to immediately connect with babies from conception to birth. After the experience of pregnancy loss, these prescriptions seem especially unforgiving, and babyloss mamas can feel extra self-blame and guilt during pregnancy and postpartum, which are notoriously difficult times for any woman. 

In particular, it is common for women who have experienced babyloss to feel unable to connect and bond with subsequent pregnancies. During these times, as a clinician, I frequently remind these grieving mothers that the inability to connect may be grounded in fear and a need to protect oneself from the pain of another loss, and that this lack of connection will not affect the outcome of their pregnancy, or their love for their child after giving birth. While falling in love immediately  may be one experience after childbirth, it is also understandable for a mother who experienced a prior loss to feel many painful and conflicting emotions. Birthing a healthy child may evoke sadness over the incompletion of the last pregnancy. It may feel surreal, as a loss mama may have never imagined that she actually could have a healthy baby. Sounds of a baby crying, and the touch of newborn skin, can feel unfamiliar and offputting. The bottom line is, reacting with emotions other than love, when meeting a rainbow baby, is normal, and self-judgment during this time is not helpful. 

Coping with Guilt

So, how can a grieving babyloss parent begin to alleviate some of the overwhelming guilt? Here are a few tips for getting started. 

Recognize, don't react. It is always helpful to recognize a feeling, and separate it from the facts. In fact, the mantra, "feelings are not facts", can be very helpful. Emotions are important, but they are not representations of external truth. Rather, they are are certain window into what is happening inside yourself. So, treat feelings as clues or queues as to what is happening inside of you: recognize, and don't react. Instead, explore what issues might be hiding underneath the guilt, as guilt can be an expression of grief. 

Validate your grief. Engaging in self-talk the moment you begin to feel guilty can help you change your perspective on it. Consider the statement, "my guilt is an expression of my grief. I am grieving". Whether you are pregnant or parenting a newborn, a subsequent pregnancy or birth does not erase the grief over the baby you lost. 

Consider a thought substitution. As part of the practice of Cognitive Behavioral Therapy (CBT), I work to help clients identify the connections between their thoughts, feelings, and actions. It is helpful to name and describe the thought associated with the feeling of  guilt. For example, a guilty thought might be: "I am not a good enough parent to my child". After identifying this thought, it can be helpful to examine the evidence for whether that thought is based in reality ("facts") or not ("feelings"). Are you really not good enough? To whose standards are you measuring yourself? You may find, in this process, that you are placing unrealistic expectations on yourself, and that, critically examining your experience as a parent, you are trying your best. So, consider creating a substitute thought to challenge the guilty one. An example might be: "Nobody is a perfect parent, but I am doing the best I can", or "My baby crying does not mean I am not a good parent; I am learning to speak her language". Writing down the thought substitution and turning to it during guilty moments can help change your perspective.

Go for grace, not guilt. On the topic of high expectations, it is more than likely that you are expecting yourself to "bounce back" after loss or childbirth. However, grief, pregnancy, and parenting, are journeys that take time, and there are many new discoveries. Instead of jumping to conclusions about how you have changed, or the people you feel you are letting down, give yourself some grace. You are not at the end of your journey, and feelings of guilt do not have to be permanent. You do not have to be the perfect parent, friend, or spouse. Rather, this is a time where you are allowed to take your time, and be gentle with your feelings. Consider transforming your guilt through Creativity and Babyloss, or even explore Continuing Bonds to help honor the pregnancy you lost. If you are postpartum, check out Postpartum 101 with a Rainbow for some suggestions on how to survive. 

You are part of a community that has experienced a tragic, unthinkable loss, and guilt and self-blame may be unavoidable, but it does not define the reality of who you are as a parent or human being. As you move forward, know that the goal is not to get rid of guilty thoughts, but to recognize and challenge them as they arise. Over time, this can truly help you heal.