Once you’ve experienced a pregnancy loss, any subsequent pregnancies are bound to cause some anxiety and worry. Some mothers establish a threshold of worry, believing if they make it through a particular milestone of pregnancy, they will be safe. Other mothers struggle with the ever-evolving underlying anxiety that can last the entire pregnancy and even postpartum.

These feelings and fears are rooted in the realization that pregnancy and childbirth are part of an incredibly fragile cycle of life. So much has to go right to bring a healthy baby into the world, and parents who never experience loss are more likely to take this reality for granted. It doesn’t matter how well you eat, exercise, or how good your prenatal vitamins are—in reality, there is so little about pregnancy that you can actually control.

When we talk about how to deal with anxiety and worry during a pregnancy after a loss, the goal is not to eliminate the feelings, it’s to manage them. Your mind, body, heart, and hormones are all telling you to protect this little life, and the best way to do that is to make choices that protect you, and reduce the impact of those spiraling anxious thoughts. It also might sound really nice to be able to actually enjoy your pregnancy and life on occasion.

With the help of relationships new and old, and establishing some new practices and tactics, the anxiety you may feel about your pregnancy after loss can become manageable. It could go from feeling like being front row at a concert where the music is way too loud to background noise. And when the volume gets turned up unexpectedly, there’s a toolbox of ways to adjust that dial yourself. Read some of our suggestions below.

Find a trusted therapist. Preferably, you have access to a therapist who has pregnancy, postpartum, and loss experience. Contacting pregnancy loss support groups, or reaching out to your genetic counselor or OB/midwife for a recommendation or referral is an excellent place to start. Commit to a regular schedule (weekly, bi-weekly) and consider planning your sessions around your prenatal appointments, which can be high-stress milestones.

Interview potential obstetricians or midwives. The reality is, few obstetricians offer consultation appointments. But if you thoughtfully make your case to the receptionist or nursing staff, you just might be able to schedule one. Midwives tend to be a little more relaxed about “meet and greets.” This is going to be an incredibly important relationship during your pregnancy after loss, and finding a good fit for your rainbow baby needs is essential. You want someone patient, flexible, and understanding about extra visits, ultrasounds, and doppler checks. Come prepared with all your questions, and if your care provider isn’t meeting your needs, don’t be afraid to move your care elsewhere.

Live like your baby is coming. Doing proactive things to prepare for your baby can be a valuable, tactile way to believe your pregnancy is going to go well. It also keeps you busy! If working on the nursery, treasure hunting for thrifted baby items, creating a baby registry, or planning a family trip for after the baby is born makes you feel like you’re going to have this baby, do it! Take the weekly bump photo. Do an art project for the baby’s room. If it feels good, go for it.

Talk it out. Keeping the anxiety and worry in your head doesn’t make it go away. It just metastasis and keeps your body in stress hormone production mode. Come up with your go-to family, friends, and mental health counselors who you can trust to listen and give you the kind of feedback that will support you best. If you just need listeners, don’t ask a sibling who has an opinion about everything. If you need objective feedback, ask the friend who is going to tell it to you straight. Your care providers should also be a trusted resource. If something just doesn’t feel right, they are just a phone call away to discuss and offer some options to consider.

Write it out. It doesn’t matter if you haven’t written anything personal since your elementary-school diary—write down what you are thinking and feeling. Sometimes just getting it out of your head calms the worry and gives you perspective. There are no rules for what is okay and not okay to say. This is just for you. Get out your biggest, scariest, wildest fears about what you’re facing with your pregnancy. Write a letter to the baby you lost and the baby you’re growing. Write a letter to yourself to read after the baby is born. Whether you set a dedicated time to write or just pick up your journal when you feel like it, the most important thing is getting your thoughts out of your head.

Advocate for yourself and your baby. Medical professionals and their staff work for you. It can often feel quite the opposite, as if they are gracing you with the privilege of their time. Either way, it is important to get comfortable asking directly for what you need. If you’ve been unable to focus for the past week because you’re worried the baby isn’t moving enough, ask for a look or listen. The dose of reassurance will dial back the anxiety and allow you enough peace of mind to get back to your day-to-day. If your care provider isn’t on board for meeting your needs, consider finding a new one.

Get a pregnancy-after-loss buddy. This one might take a little leg work, but if you get lucky, this relationship is a game-changer. Pregnancy loss support groups, both in-person and online, are a great place to find another mama who is expecting after a loss. Your due dates might not line up perfectly, but having a text thread going for those nine months with someone who understands what you’re feeling can offer an invaluable stream of support and comfort. Consider searching pregnancy loss hashtags or blog posts about loss for accounts and commenters who appear to be in the same boat as you! The worst thing that can happen is they say no.

Consider if medication might be right for you. There are anti-depressants and anti-anxiety medications that are considered to be safe during pregnancy. If you are using all the other tools in your toolbox to manage your anxiety and it still just feels like too much, your obstetrician or midwife can refer you to a therapist who can help you decide if medication could be an effective way to get the extra support you need.

Stay off the internet. You are truly your own worst enemy with this one. The compulsive need to ask the internet everything can quickly send you down a message board thread trail that probably won’t yield any answers, just more questions and worry. If you have a question, ask your care provider or a fellow mom. That pregnancy insomnia is certainly no help in keeping you offline when you’re worrying about something in the middle of the night. If you know you need to give yourself a break from Googling, you can have a partner or friend block the sites you’ll most likely be looking at on your phone or computer.

Remember that most babies are born healthy. The best and worst part about losing a pregnancy is that the statistics are usually in your favor that everything will be just fine. When you’re the exception to that rule, your relationship to those statistics changes, and you may begin to believe lightning can actually strike twice. Most likely, it won’t. When you feel that anxiety creep in, just remind yourself that most babies are born healthy, and it might take the edge off how you’re feeling.

What about you? Have you made it through a pregnancy after loss? What are your words of wisdom for all those rainbow mama’s-to-be?

Emily Thompson is a writer, producer, and creative director based in the Pacific Northwest. She lost her first baby in January of 2019 at 23 weeks, and uses her writing to keep the memory of her daughter alive, and explore her experience of grief and healing. She is expecting her rainbow baby in March of 2020.