During the diagnosis and treatment stages of an ectopic pregnancy there can be so many worries and decisions to make that it can be difficult to think about the future and may take time for your emotions to surface properly.
Being monitored or treated for an 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 has 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.
You may experience 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 also very understandable emotional responses. Ectopic pregnancy can sometimes trigger physical symptoms such as palpitations, patchy sleep, poor concentration, agitation and dizziness. It is important to remember that the ectopic pregnancy was not your fault and that there was nothing you could have done to prevent it happening.
In ectopic pregnancy you lose a baby, part of your fertility, face your mortality (risk to your life) and are left with huge unanswered questions about the future. It is only natural that you will experience many emotions. Below is a list of common questions that we are asked about emotions. Please click on any of the questions below that interest you and they will expand into a detailed answer. If there are any questions that you don’t see the answers to here, you may find them on our ectopic pregnancy discussion forums or you could email us at firstname.lastname@example.org.
- My Feelings
I am experiencing flashbacks/nightmares, what is wrong with me?
It is not uncommon to 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.
This is a sign of Post-Traumatic Stress (PTSD) which is normal to experience after a traumatic event and will usually improve naturally over a few weeks. NHS Choices recommends you should visit your GP if you are still having problems with this symptom about four weeks after the traumatic experience, or if the symptoms are particularly troublesome.
I’ve lost all my energy and can’t be bothered to do anything, is this normal?
It is very common for people lose interest in day-to-day activities and avoid social situations after an ectopic pregnancy. You may have a feeling that you don’t care about anything, feel detached from other people and then frustrated that they don’t seem to understand how you feel. If this continues for more than a few weeks, you may be depressed. If this is the case, it would be worth talking to your GP who may be able to help arrange some counselling or medication that could help.
Am I depressed?
Depression is more than simply feeling unhappy or fed up for a few days. We all go through spells of feeling down, but when you’re depressed you feel persistently sad for weeks or months, rather than just a few days. It is nothing to feel embarrassed by it as it is very, very normal given everything you have been through and the World Heath Organisation says 5% of the community suffers it per year so it is very common and strikes everyone from politicians (Alistair Campbell is famously outspoken on the subject), through to pop stars (Robbie Williams talks openly) through to comedians (Stephen Fry), through to dentists, miners, doctors, teachers, electricians etc etc.
Depression isn’t a weakness or something that can just be snapped out of, it is a natural reaction to losing a baby and nearly losing your life. The charity Mind lists the following symptoms of depression and, if you tick off five or more of any of them, you are probably depressed:
- I am low-spirited for much of the time, every day
- I feel restless and agitated
- I get tearful easily
- I feel numb, empty and full of despair
- I feel isolated and unable to relate to other people
- I am unusually irritable or impatient
- I find no pleasure in life or things I usually enjoy
- I feel helpless
- I have lost interest in sex
- I am experiencing a sense of unreality
- My behaviour
- I’m not doing activities I usually enjoy
- I am avoiding social events I usually enjoy
- I have cut myself off from others and can’t ask for help
- I am self-harming
- I find it difficult to speak
- My thoughts
- I am having difficulty remembering things
- I find it hard to concentrate or make decisions
- I blame myself a lot and feel guilty about things
- I have no self-confidence or self-esteem
- I am having a lot of negative thoughts
- The future seems bleak
- What’s the point?
- I have been thinking about suicide
- My physical symptoms
- I have difficulty sleeping
- I am sleeping much more than usual
- I feel tired and have no energy
- I have lost my appetite, and am losing weight
- I am eating a lot more than usual and putting on weight
- I have physical aches and pains with no obvious physical cause
- I am moving very slowly
- I am using more tobacco, alcohol or other drugs than usual
Depression presents itself in many different ways. You may not realise what’s going on, because sometimes your problems seem to be physical, rather than mental or emotional. It’s important to seek help from your GP if you think you may be depressed. Many people wait a long time before seeking help for depression, but it’s best not to delay. The sooner you see a doctor, the sooner you can be on the way to recovery.
I just feel numb and have no feelings, is there something wrong with me?
Sometimes, after an emotionally overwhelming incident like an ectopic pregnancy, you may experience a sense of numbness or emotional blunting, like you don’t have any feelings left because they have all gone. It can feel like you don’t know where to start to get your feeling back or how to figure out exactly what you are feeling. This is common and a very normal reaction. Sometimes people then feel guilty for feeling numb.
If this continues for more than a few weeks, you may be depressed and would benefit from further support. If this is the case, it would be worth talking to your GP who may be able to help arrange some counselling or medication that could help.
Grrrr, I feel so angry!*?
Anger is another common response to the trauma you have suffered. You may feel angry because of what has happened to you, angry because you don’t feel in control of your fertility any more, and angry with others for making you suffer either deliberately or unwittingly. This is a normal response that passes.
Even though it may be hard, it is important that you try to communicate these feelings so that others understand you emotionally and to get the feelings ‘off your chest’.
I am not happy with my treatment, what should I do?
We would recommend that, if you are not happy with the treatment your hospital has provided, that you contact your hospital’s Patient Advice and Liaison Service (PALS). If you ring the hospital switchboard they should be able to put you through. These volunteers would assist you in complaining or help you to get the relevant medical support from the hospital.
I really want to look at my medical records, can I?
Yes, you can. If you wish to view your health records, it may not be necessary for you to make a formal application to do so. Nothing in the law prevents health professionals from informally showing you your own records. You could make an informal request during a consultation, or by ringing the surgery or hospital and arranging a time to visit and see your records.
However, if you wish to make a formal request to see your health records under the Data Protection Act, you should apply in writing to the holder(s) of the records. If you wish to see your GP records, you should write directly to your GP or to the Practice Manager. If you wish to see your hospital records, you should write to your hospital Patients Services Manager or Medical Records Officer.
You may be charged a fee. More details on how to obtain your records and the fees involved can be found on the NHS Choices website.
Is the ectopic pregnancy my fault?
Some women start blaming themselves for what happened and feel guilty about the ectopic pregnancy, like they have chosen to terminate their baby. 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. You had no choice other than to be treated for your ectopic pregnancy as you would have internally bled to death if you had not had treatment.
Some women also think it is their fault because they smoked or caught Chlamydia from a partner. Again, it is not your fault. Please remember that for more than half of the UK’s ectopic pregnancies, there is no link, risk or factor known to cause the condition associated with the ectopic pregnancy. If you had Chlamydia, it is impossible to tell if this was the case because the only way we would know would be to remove the tube and examine it to see if there was evidence of scarring associated with the infection.
It is important to remember that even after an ectopic pregnancy there is a chance that your remaining tube is unaffected, even if the tube you lost was damaged by the disease. Chlamydia does not necessarily cause damage equally to both tubes.
Am I grieving?
You have lost your baby, hopes and dreams in a sudden and very distressing way so it is natural that you would be grieving the loss of your little one. Grief is the, very normal, emotional suffering we feel after a loss and is actually a healing process. During grief, it is common to have many conflicting feelings, such as sorrow, anger, loneliness, sadness, shame, anxiety, and guilt.
Having so many strong feelings can be very stressful. Yet denying the feelings 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.
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 and their lives can be painful until they move to the fifth stage – acceptance.
Five Stages of Grief:
- 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.
- Anger – We may then be furious at the person who inflicted the hurt (even if she’s dead), at the world for letting it happen or angry with ourself for letting the event take place, even if, realistically, nothing could have stopped it.
- Bargaining – Now the grieving person may make bargains with God, asking, “If I do this, will you take away the loss?”
- Depression – The person feels numb, although anger and sadness may remain underneath.
- Acceptance – This is when the anger, sadness and mourning have tapered off. The person simply accepts the reality of the loss.
When will I feel better?
There is no easy answer to this as everyone deals with emotion differently. However, we do know that grieving and its stresses pass more quickly with good self-care habits. It helps to have a close circle of family or friends and to talk about how we are feeling. If it is not easy to talk to friends and family, then the ectopic pregnancy discussion forums could be invaluable. It also helps to eat a balanced diet, drink enough non-alcoholic fluids, get exercise and rest.
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 it is important we 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.
I feel so jealous around other pregnant women, am I a bad person?
The most commonly shared emotion among women who have suffered an ectopic pregnancy is the discomfort and jealousy felt around other pregnant women or when a friend announces they are pregnant. This is usually coupled with the sense of not wanting to go anywhere near them and the overwhelming guild that is then felt for feeling this way. First and foremost, you are not a bad or unkind person for feeling this way and there is nothing wrong with you; this feeling is totally normal.
Women who are recovering from an ectopic pregnancy often feel very shocked at their own reactions in this situation but 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. Many women find it therapeutic to share these feelings on our ectopic pregnancy discussion forums where they can safely and privately express their emotions among others who understand how they are feeling.
- My Family’s Feelings
How is my partner likely to feel?
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.
Reading the page about Dads and Ectopic Pregnancy might be helpful.
How will my other children feel?
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 and making sure that children are given an age-appropriate explanation about what has happened, along with plenty of reassurance and cuddles.
How will my parents feel?
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 best 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.
What is counselling?
Counselling is an umbrella term for a number of ‘talking therapies’. Different counsellors use different techniques, so you have to choose your counsellor carefully if you are not being referred by a GP. The British Association of Counselling and Psychotherapy explains counselling as:
“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.”
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.
When is this the right time for counselling?
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 a baby through ectopic pregnancy to please be gentle with yourself and allow yourself the time you need to grieve.
If, some time on, 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?
Unfortunately, there is little regulation of talk therapies in the UK and anyone can call themselves a counsellor with very little or no training. Therefore, if you are looking for a counsellor, we suggest that you ask for a referral by your GP or use a practitioner who has undertaken recognised training and is registered with the British Association of Counselling and Psychotherapy.
The charity MIND also can provide counselling with trained practitioners locally at affordable prices. Counselling charges are means tested (you pay what you can afford) and so you may receive counselling support for a nominal fee or even for free.
- Suggestions for Recovery
There is no time limit to recovery from an ectopic pregnancy. It is common to think that you should get back to work and get “back to normal” as soon as possible, but there is no ‘should’ when it comes to recovery, only what feels right for you. We regularly consult women who have experienced ectopic pregnancy, and as a result of our research into recovery have developed this list of suggested ideas about how you might spend some of your time following your treatment. Although this is not an exhaustive list, and everyone has their own unique way of coping with their loss, we hope that you might find something useful here to help yourself to recover and deal with what has happened.
Talking about your feelings with trusted friends can be a great way to take away some of the emotional pressure. You may find, at this point, there will only be certain people that you want to see and talk to and who you trust to say the right thing.
Sometimes we feel that we cannot talk to our friends and family, or need to discuss the same things again but our friends and family don’t want to listen to it again or we don’t want to discuss it with them a second time. Sometimes we just want to seek out people who know what we’re going through. If this is the case, visit our ectopic pregnancy discussion forums where there are many women and men who have experienced ectopic pregnancy and who are also looking for people to talk to. It is a safe and private environment that is overseen my medical professionals. Many strong and long-lasting friendships have been built here.
You are also very welcome to phone us on the EPT helpline 020 7733 2653. Our trained helpline operators, who have direct experience of ectopic pregnancy, will listen to you and answer any questions you have. You do not need to feel alone. There are many women using our services who have been through an ectopic pregnancy.
Light a candle
On our website is a special place where you can light a candle in remembrance of your baby. Alternatively, some women and their partners like to plant a tree or buy a piece of jewellery to commemorate their baby.
Use your friends
When your trusted friends or relatives come to see you, ask them to bring you any films or DVDs they think you’ll like, books or magazines they think you’ll enjoy reading or anything else they know you might be interested in. If people offer to go to the shops for you, let them. It will make them feel good!
If you feel it’s a duvet day, then let that happen. Catch up on films you’ve been meaning to watch but haven’t had the chance to. Try not to feel guilty about indulging yourself if that’s not the kind of thing you usually do. Ectopic pregnancy is exhausting and many women feel that they are not able to do much more than sit in front of the television. This is okay.
Amongst the feelings of sadness you may feel extremely angry at what has happened. Expressing these emotions in a controlled way can prevent them from bubbling beneath the surface and bursting out when you least expect, or want, them to. Punching a pillow also helps to relieve tension if you feel angry.
Book a haircut, massage, manicure or pedicure if that will help you feel good. Massage not only helps you to relax by calming the nervous system but increases oxygen flow in the body encouraging healing and also help to balance the endocrine system which controls hormone levels. If you’re well enough, you can go to a salon or spa, and there are mobile therapists who will come to your home. If you’ve had surgery tell the therapist and they will avoid the areas affected.
Food is proven to affect mood, so help yourself by eating healthily for most of the time. Take note of good-mood foods such as turkey, chicken, milk, eggs, cheese, fish, nuts and seeds, which are all rich in tryptophan, an amino acid which helps the brain to produce serotonin to make your mood stable and encourage healthy sleep. If you are being treated with methotrexate it is very important that you avoid foods enriched with folic acid until your hormone levels have fallen to below 5<mIU/mL.
A new focus away from due dates
Most women feel that once they’ve healed physically, the emotional recovery begins. You may find at this point that you need a goal or distraction to work towards as an alternate focus to what would have been your due date. A great way to do this is set yourself a physical challenge or take up a new activity. Obviously wait till you’ve totally recovered from any surgery, and you should be led by your health care providers about that, but once healed, it doesn’t matter what your level of fitness, any kind of exercise will release feel-good endorphins into your body, increased oxygen will enable the body to heal itself quicker and you’ll be able to build up your strength physically and mentally. This will, of course, also benefit you whether or not you decide to try to conceive again.