It is not uncommon for women to struggle in pregnancy with their changing bodies. Even when a woman gains the amount of weight suggested by medical guidelines, she may feel uncomfortable or unfamiliar with the changes in her body. She knows that a baby is growing inside her and yet she can at times feel “invaded” by this being who is the cause of all kinds of changes, good and bad. Some women feel great in pregnancy and love the sensations that occur inside the body. Some women love the changes to their body shape and the growing belly that facilitates a shift in identity towards becoming a mother. Others feel terrible due to nausea and may wish for the weeks to fly by in order to feel better. Even when morning sickness is not a factor, the weight gain that accompanies pregnancy may cause distress.
In a pregnancy subsequent to a pregnancy loss, the picture can become even more complicated. When a pregnancy ends too soon a woman is left with empty arms but a body that may suggest otherwise. It can be painful to interact with others in the immediate aftermath of a loss when one’s body has not yet returned to its pre-pregnant state. This takes time. Not fitting into one’s old clothes becomes a source of turmoil as women no longer want to wear maternity clothes when there is no longer a pregnancy.
In my clinical practice, I meet with many women in this “in between stage.” They have just lost a baby and are grieving. Looking in the mirror is a painful experience to see the shape of a mother but not have a sleeping baby in the next room can remind one of everything that has been lost. After my pregnancy loss, a child asked me if I was pregnant. I am sure I said I wasn’t. Although I don’t remember my exact words, I’ll always remember how I felt. It was a huge mix of different emotions: sadness, anger, and most notably shame. The shame was about my body not conforming to the world’s idea of what a non-pregnant woman should look like. I felt like an imposter, a woman who was just pretending to be pregnant. I wanted to spend the next week hiding in my house in yoga pants from the first trimester. Simultaneously, I wanted to tell everyone that I was pregnant. “No, really, there was a baby in here.” While some of the weight eventually came off, my body never looked like it did before. And then I was pregnant again and had new things to worry about.
There are other complications stemming from body changes in pregnancy. When a new pregnancy occurs, women often show sooner than in the prior pregnancy. This poses a dilemma for women who wish to keep the pregnancy a secret until a later date. Some women look forward to getting bigger as a way to measure growth and feel reassured that the baby is thriving.
How a woman feels towards her body during a pregnancy after loss will depend on a number of factors including her prior relationship to her body and what it means to her be pregnancy currently as well as the specifics of the loss she experienced. There is no right or wrong way to feel.
For clinicians working with pregnant women, especially those who have suffered previous perinatal losses, it can be challenging to address some of these issues because women may feel reluctant to bring forward body image concerns. There may be shame or guilt about having such concerns when they are “supposed” to just focus on having a healthy baby. I encourage clinicians to listen carefully for body-related concerns in a pregnancy after loss and to ask clients about their relationships with their changing bodies. Pregnancy is such an amazing physical feat and it makes it hard to pretend not to have feelings about all of the changes taking place. In pregnancy after loss, the aches and pains of pregnancy may be nothing compared with the emotional aches and pains a woman is experiencing.
Encourage your clients to have self-compassion and to recognize that the loss may make their experience of their bodies more complicated.