Navigating an Uncertain Journey of Pregnancy After Perinatal Loss

The purpose of this qualitative data analysis was to gain insights into women's experiences over the course of pregnancy subsequent to prior perinatal loss. Diaries from 19 pregnant women with a history of miscarriage, stillbirth, or neonatal death who participated in an intervention study were the data source. The participants were primarily Caucasian, 23 to 41 years old, with a history of one to six prior losses, high school to graduate school education, and a wide range of incomes. Inductive thematic analysis of pregnancy diary entries was done. A metaphor of navigating a pregnancy journey that feels scary and uncertain, toward the goal of reaching their desired destination, a healthy infant, was identified from women's personal accounts. Six themes were identified: (a) Staying Alert: Noting Physical Symptoms, (b) Dealing with Uncertainty: Expressing Emotions, (c) Dreaming of the Destination: Evolving Thoughts of Baby, (d) Traveling Together: Connecting with Others, and (e) Moving Forward: Reflecting on Sense of Self. The interaction of several themes is described as (f) Staying on Track: Navigating through Pregnancy. Women may find journaling helpful in dealing with the anxiety and fear that characterize pregnancy after loss. Viewing pregnancy after perinatal loss as similar to navigating an uncertain journey may provide greater understanding of the emotional, physical, and social challenges that women may experience. Recognition that women with a history of perinatal loss may be anxious and fearful during pregnancy will increase sensitive care