The EPT

Your emotions

Until you begin to feel a little better and more healed physically,  it can be difficult to think about the future and it may take time for your emotions to surface properly. Being monitored or treated for ectopic pregnancy is a worrying experience for any woman, and until your hCG levels drop, which can take several weeks, you may still ‘feel’ pregnant. Once the hormones do fall and the doctors confirm the pregnancy is ended, it is not unusual to feel low in mood and sometimes even a little depressed. We are all different and we all react and recover in different ways - there is no right or wrong way and there is no time frame. It is, however, important to give yourself sufficient time to recover on a physical, psychological and emotional level. Feelings can change dramatically in the first few weeks and months after an ectopic pregnancy.

Some typically  experienced psychological and emotional reactions

• You may find yourself reliving some aspects of the diagnosis and treatment of your ectopic pregnancy in the form of intense memories. These are called flashbacks. You may also experience nightmares or bad dreams and frightening thoughts. Some people also experience physical reactions to situations that remind them of the traumatic event. This repeated reliving of what happened could disturb your day-to-day activities and functioning, and result in a lack of interest in normal activities.
• At other times you may experience a sense of numbness, emotional blunting, or perhaps even a feeling that you don’t care about anything. You may feel detached from other people and then frustrated that they don’t seem to understand how you feel.
• You are likely to experience a wide range of different emotions, such as fear, anger, sadness and guilt. In the immediate aftermath you may feel vulnerable, the world might seem threatening, and the future uncertain. Fear and panic are therefore very understandable emotional responses. Anger is another common response. You may feel angry because of what has happened to you, angry because you don’t feel in control of your fertility any more, angry with others for making you suffer either deliberately or unwittingly. Some start blaming themselves for what happened and feel guilty about the ectopic pregnancy. Some may experience survivor guilt (guilt over surviving while the baby did not). It is very important that you acknowledge that there was nothing you could have done to stop the ectopic pregnancy from happening and that it is not your fault.
• Ectopic pregnancy can sometimes trigger physical symptoms such as palpitations, patchy sleep, poor concentration, agitation and dizziness.
• The experience may even rekindle feelings of previous loss, which had perhaps been buried and which you thought you had dealt with.
• The experience often  leads to a reassessment of your vulnerability and the meaning of life, and you may feel that what has happened has completely changed your life.
• The experience may make you feel more protective towards your existing children, if you are already a parent, and you can feel overly concerned for them when they aren’t with you.

It is important to realise that all of the above reactions, and many others, are understandable and normal responses to an abnormal and overwhelming event.

The RCPsych leaflets on anxiety and phobias and on Post Traumatic Stress Disorder may be of further help to you.

Your partner’s emotions

Partners can sometimes find it difficult to understand your feelings and you may feel that your partner isn’t supporting you. They can also feel left out and ignored. Your partner’s focus is likely to be on you rather than the lost pregnancy, and this can be difficult to accept. It is important that when you feel able to, you talk to your partner both about your feelings and about theirs.

Partners often have a sense that they want to try and make it better or to fix what has happened in some way. This can be demonstrated by your partner being overly helpful or trying to distract you by taking you out, organising a trip or just encouraging you not to dwell on what has happened. This is not because they don’t care about what’s happened.

You can help your partner by reassuring them that when you talk to them about the ectopic pregnancy, that if you become upset and tearful, you don’t need them to try and fix it - you just need them to listen and support you.

The emotions of other children

Even very young children can sense when the person they are used to caring for them is distressed or upset. Toddlers often feel that they may have done something to cause their mother to be unhappy and an older child who understands the condition more, often worries for their parent’s future well-being. This can be overcome with honesty, making sure that children are given an age-appropriate explanation about what has happened, along with plenty of reassurance and cuddles.

The emotions of parents

Parents often worry dreadfully for their children and they too may have an overwhelming desire to try to make it better. This can sometimes manifest  itself by a parent trying to change the focus on to other more cheerful things if you become upset and tearful when talking to them. Making it clear what kind of support you need  from people can help to avoid confusion between you and others about how they can support you.

Being honest with the people around you and not expecting them to know how you are feeling, or how you need them to respond to you, can help to reduce the confusion felt by everyone when recovering from the impact of an ectopic pregnancy.

Feelings toward other pregnant woman

Some people feel very uncomfortable about the pregnancies of other women. This can be especially hard if a friend or relative becomes pregnant soon after your loss. Women who are recovering from an ectopic pregnancy often feel very shocked at their own reactions in this situation. Anger, guilt, hatred, loathing or just a sense that it’s just not fair are all commonly reported.  It can take time to realise that you are grieving for the baby you and these feelings are normal.

For more help with coping after a traumatic event the RCPsych online leaflet is recommended.

Grieving and talking

What is grieving and when will I feel better? Do I need counselling?
At some point in our lives, each of us faces the loss of someone or something dear to us. The grief that follows such a loss can seem unbearable, but grief is actually a healing process. Grief is the emotional suffering we feel after a loss of some kind. The death of a loved one, loss of a limb, even intense disappointment can cause grief. Dr. Elisabeth Kubler-Ross has named the five stages of grief people go through following a serious loss. Sometimes people get stuck in one of the first four stages. Their lives can be painful until they move to the fifth stage – acceptance.

Five Stages Of Grief
1. Denial and Isolation.
At first, we tend to deny the loss has taken place, and may withdraw from our usual social contacts. This stage may last a few moments, or longer.
2. Anger.
The grieving person may then be furious at the person who inflicted the hurt (even if she’s dead), or at the world, for letting it happen. He may be angry with himself for letting the event take place, even if, realistically, nothing could have stopped it.
3. Bargaining.
Now the grieving person may make bargains with God, asking, “If I do this, will you take away the loss?”
4. Depression.
The person feels numb, although anger and sadness may remain underneath.
5. Acceptance.
This is when the anger, sadness and mourning have tapered off. The person simply accepts the reality of the loss.

Grief And Stress
During grief, it is common to have many conflicting feelings. Sorrow, anger, loneliness, sadness, shame, anxiety, and guilt often accompany serious losses. Having so many strong feelings can be very stressful. Yet denying the feelings, and failing to work through the five stages of grief, is harder on the body and mind than going through them. When people suggest “looking on the bright side,” or other ways of cutting off difficult feelings, the grieving person may feel pressured to hide or deny these emotions. Then it will take longer for healing to take place.

Recovering From Grief
Grieving and its stresses pass more quickly, with good self-care habits. It helps to have a close circle of family or friends. It also helps to eat a balanced diet, drink enough non-alcoholic fluids, get exercise and rest.
In ectopic pregnancy you lose a baby, part of your fertility, face your mortality and are left with huge unanswered questions about the future. It is only natural that you will grieve, and may feel:
Angry?
Upset?
Sick to your stomach?
Hurt?
That it was out of your control?
Defiled?

To feel like this after a loss is a very healthy, normal response. We would change the feeling of pain if we could, but we can’t change it because we have to go through it. It is a normal part of the grieving process. Many women find support in our message boards or by talking through how they are feeling with an EPT Helpline operator. Communicating with other people who have experienced a similar loss can relieve some of the isolation, and help to make sense of how we are feeling.

Do I need counselling?
If after many months you are still tearful all the time, are feeling bereft, can think of nothing else, cannot move on a little, and don’t feel that there are ever any good days then counselling can be invaluable.

What is counselling?
Counselling is an umbrella term for a number of ‘talking therapies’. Different counsellors, use different techniques in their surgeries so you have to choose your counsellor carefully, if you are not being referred by a GP. Did you know that ANYONE can call themselves a counsellor? Therefore, if you are looking for a counsellor, we suggest that you use a practitioner who has undertaken recognised training and is registered with the BACP. This is the BACP’s definition of counselling:

‘Counselling takes place when a counsellor sees a client in a private and confidential setting to explore a difficulty the client is having, distress they may be experiencing or perhaps their dissatisfaction with life, or loss of a sense of direction and purpose. It is always at the request of the client as no one can properly be ‘sent’ for counselling.

By listening attentively and patiently the counsellor can begin to perceive the difficulties from the client’s point of view and can help them to see things more clearly, possibly from a different perspective. Counselling is a way of enabling choice or change or of reducing confusion. It does not involve giving advice or directing a client to take a particular course of action. Counsellors do not judge or exploit their clients in any way.

In the counselling sessions the client can explore various aspects of their life and feelings, talking about them freely and openly in a way that is rarely possible with friends or family. Bottled up feelings such as anger, anxiety, grief and embarrassment can become very intense and counselling offers an opportunity to explore them, with the possibility of making them easier to understand. The counsellor will encourage the expression of feelings and as a result of their training will be able to accept and reflect the client’s problems without becoming burdened by them.

Acceptance and respect for the client are essentials for a counsellor and, as the relationship develops, so too does trust between the counsellor and client, enabling the client to look at many aspects of their life, their relationships and themselves which they may not have considered or been able to face before. The counsellor may help the client to examine in detail the behaviour or situations which are proving troublesome and to find an area where it would be possible to initiate some change as a start. The counsellor may help the client to look at the options open to them and help them to decide the best for them.’

Is this the right time?
Most good counsellors will tell you that there is a ‘time’ for counselling. Grief following an ectopic pregnancy can sometimes feel so painful that it is excruciating, and so we consider ways to fix the pain and fast. Often at this early stage in our grief we consider counselling as we find ourselves considering anything to help alleviate the pain and grief. Some people use alcohol, others shout – we all react in different ways, and sometimes we think about counselling.

Counselling can be extremely effective at the right time but it is not a quick fix and it won’t take away the pain of first grief. That experience of grief, scary as it may be, is healing and forms part of your own recovery from one of the most significant events likely to have happened in your life. We urge women who have experienced the loss of an ectopic pregnancy to please be gentle with yourself and allow yourself the time you need to grieve.

If, some time on, as mentioned above, you are still tearful all the time, feeling bereft, can think of nothing else, cannot ‘move on’, and don’t feel that there are ever any good days, then counselling can be a very useful step.

How do I find a counsellor?
Please have a look at this useful information from the BACP.