Your emotions after an ectopic pregnancy

 

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. Your initial feelings may range from shock and disbelief, emptiness, relief, anger, sadness, guilt, jealousy, anxiety or worry. You may also find that the ectopic pregnancy has affected your partner, your relationship, your hopes and plans for a family, and you may find yourself having to break the news to the extended family, friends and colleagues.

This section will aim to help you make sense of some of the more common reactions and how to deal with those, including what you can do to cope with your feelings and when to seek help from a professional. It is important to remember that there is no right or wrong way of feeling and that everyone is different depending on your individual circumstances.

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 ept@ectopic.org.uk.

What emotions can I expect to feel early on?

For most women and couples, the time between a positive pregnancy test and having a confirmed ectopic pregnancy is very short and confusing. 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. 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. Physically you may also need to give yourself time to recover and it may not be possible to return to daily activities straight away. Some people feel the need to block out their feelings and “get on with life”, and whilst that can be helpful from time to time to allow yourself to carry on with necessary tasks, it is also important to allow yourself the time to process what has happened. Feelings of sadness or grief are a normal reaction to a difficult life event and you will recover quicker if you accept those feelings and allow yourself time to process them.

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. Thoughts about the ectopic pregnancy can sometimes trigger physical symptoms such as palpitations, patchy sleep, poor concentration, agitation and dizziness. These symptoms will often go away with time, however if they continue for more than 4-6 weeks you may want to discuss them with your GP.

Why did this happen to me?

Ectopic pregnancies are not universally known about and most people do not expect for it to happen to them. For most people, it is a natural response to try to make sense of what and why it happened to them. Trying to make sense of why you had an ectopic pregnancy can be difficult and frustrating as there often are no perfect answers to your questions. You may be angry with your doctors for not being able to provide you with satisfactory answers or for being given different answers from various professionals.

Some women may end up blaming themselves for having caused or contributed to the ectopic pregnancy and feel guilty. 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 may 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 cause 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. If you had chlamydia and lost one of your fallopian tubes as a result of ectopic pregnancy, it is important to remember that 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.

My Feelings

I am experiencing flashbacks/nightmares, what is wrong with me?

By far the most common emotional reaction after having an ectopic pregnancy is finding yourself suddenly overcome with intense emotions of reliving some aspects of the diagnosis and treatment of your ectopic pregnancy when you did not want to. You may also get palpitations, or feel anxious or agitated when reminded of the ectopic pregnancy. These are called flashbacks. You may experience nightmares or bad dreams and have a sense of being “on edge”, irritable, or more anxious. Some women also experience a sense of being detached and numb and that the ectopic pregnancy has changed them in some negative way.

If these symptoms persist for more than four weeks and impact on your ability to carry on your daily routine, you may have Post-Traumatic Stress (PTSD). This is by far the most common emotional reaction and there are some suggestions that it affects as many as 40-50% of women after an ectopic pregnancy. NHS Choices recommends you should visit your GP if you are still having problems 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 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. 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, detached and/or irritable for weeks or months, rather than just a few days. If you suspect that you might be depressed, we recommend that you complete the short depression screening questionnaire.

The questionnaire will automatically calculate your score for you. If your score is 10 or above, we recommend that you speak to your GP about the possibility that you are depressed. Depression is not a weakness or something that can just be snapped out of, it is a natural reaction to losing a baby and possibly nearly losing your life. If you are feeling depressed, it is nothing to feel embarrassed about. We can’t emphasise enough that it is very, very normal given everything you have been through.

 

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 emotions back or how to figure out exactly what you are feeling. This is common and a very normal reaction and happens when the mind is too overwhelmed to process everything that has happened to you, so it is shutting off some feelings. It is important that you allow yourself the time to process what has happened and try to reach out to people who are supportive and whom you can talk to. This sense of numbness tends to reduce over time, however, if you are still experiencing numbness for most of the time a month after the ectopic pregnancy, especially if this feeling is accompanied by other symptoms such as flashbacks or anxiety, we recommend that you go and talk to your GP about how you are feeling.

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’. Some people also find that exercise, art, writing, or music can help them cope with their angry feelings. If you like music, one tip is to put on some music that expresses your feelings initially and then gradually calm the music down until you are feeling better.

I am not happy with my treatment, what should I do?

If you are not happy with the treatment your hospital has provided, we recommend 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 will assist you in making a complaint 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.

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 and sometimes also part of your fertility. 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 and sometimes there may be a temptation to avoid these feelings and “move on” with your life. 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. Whilst most people will have to put their feelings aside at times to be able to function, you will recover quicker if you accept all your feelings associated with the loss and embrace them as a natural part of recovery.

Dr. Elisabeth Kubler-Ross has named the five stages of grief people go through following a serious loss. It is important to remember that this is not a linear process and some people may be surprised to experience grief after an ectopic pregnancy many years after the event. 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:

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 – We may then be furious at the person who inflicted the hurt (even if they are dead), at the world for letting it happen or angry with yourself for letting the event take place, even if, realistically, nothing could have stopped it.
3. Bargaining – Now the grieving person may make bargains e.g. 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.

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 it’s 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.

Try not to ignore your feelings, but at the same time, you may feel the need to distract yourself from time to time in order to function in your day-to-day life. We recommend that you try to strike a balance between processing what has happened and getting on with your daily life and responsibilities. Many people feel that it is helpful to have a daily routine to fall back on at times of stress. Music and the arts can also be very healing; write a blog, take up painting or find the perfect song to describe how you are feeling, etc. 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 guilt 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 that you lost 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 is not 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 our guidance for 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.

Counselling

What is counselling?

Counselling is an umbrella term for a number of talking therapies. Different counsellors or psychologists use different techniques, so you have to choose your counsellor or psychologist carefully if you are not being referred by a GP. We recommend that you find a counsellor or a psychologist who is registered with a professional body and who have experience of supporting women or couples after pregnancy loss. The main professional bodies in the UK are: Health Professions Council, the British Association of Counselling and Psychotherapy, and UK Council for Psychotherapists and you can use their websites to find registered members.

Do I need counselling?

Accessing counselling is an individual decision and if you think that you would like to talk about what has happened and you find it difficult to talk to friends or family about it, then you may benefit from talking to a counsellor. Also, if you are still tearful all the time, are feeling bereft, have flashbacks or nightmares, feel anxious, can think of nothing else, cannot move on a little, or don’t feel that there are ever any good days a few months after the ectopic pregnancy then it is a good idea to see a psychologist or an experienced counsellor.

When is this the right time for counselling?

There is not right or wrong time for counselling, but if you are considering it, it may be a good idea to make an appointment. Most people delay and hope that time will heal, however, you are likely to feel better sooner if you seek help. If you remain very distressed about the ectopic pregnancy more than 4-6 weeks afterwards and it is impacting on other areas on your life, such as your work or every day duties, your relationship with your partner, your relationship with the extended family or friends, or your personal well-being, it is a good idea to seek professional help.

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. It is also a good idea to look for someone who has an interest in the area of women’s health or fertility problems.

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.

If you are having difficulties relating to your partner after the event, we recommend that you look for a local Relate counsellor that specialises in couple’s therapy.

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. Some people feel the need to get back to a familiar routine as soon as possible afterwards whereas others need to wait a bit longer. It is important to allow yourself time to process what has happened at your own pace.

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.

Talk

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 by 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

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!

Relax

If you feel it is a duvet day, then let that happen. Catch up on films you have 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.

Channel your anger

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. Exercise can help relieve tension if you are angry and some people also find it helpful to punch a pillow, write down your feelings, listen to loud music or paint.

Pamper yourself

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.

Eat well

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 hCG hormone levels have fallen to below 5 iu/l.

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 is, 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.