Fetomaternal Hemorrhage Can Go to Hell Part 2: Innocence Lost

Many loss mamas talk about losing their pregnancy innocence after experiencing miscarriage, stillbirth, or infant death. Suddenly they become acutely aware that two pink lines on a home pregnancy test does not guarantee the safe arrival of a healthy baby nine months later. While pregnant with Leah, my anxiety prevented me from enjoying this optimistic outlook (which the jaded among us might call naivete, given that 1 in 4 women will experience pregnancy or infant loss in their lifetime). I always consoled myself that, once Leah arrived safe and healthy in my arms, I would be able to enjoy subsequent pregnancies because I would have a solid life precedent to confirm that my body is capable of carrying a healthy, full term baby.


Image credit: Charles M. Schulz

But Fetomaternal Hemorrhage changed all that. Not only did FMH (also called Fetal-Maternal Haemorrhage and Fetomaternal Transfusion) snatch my baby girl’s life away, but it also stole my ability to ever feel “safe” in subsequent pregnancies.

Long story short, FMH has all the trappings of an anxious-control-freak-expectant-mother’s worst nightmare. Here’s why:

  1. A massive FMH is incredibly rare. Like, 1 in 5000 pregnancies rare. Many doctors have never heard of it. The specialist who oversaw Leah’s palliative care had only ever seen one other case of it in his 30 year medical career. Which means that…
  2. …there is very little research on potential risk factors, how to detect it, and what can be done to prevent it.
  3. In most cases, it has no known cause. Trauma to the abdomen can be a factor, as can placental abruption and particular blood clotting diseases. But for the most part, it happens in perfectly healthy and complication-free pregnancies.
  4. Usually, the baby’s decreased movements are the only sign that anything is wrong, at which point the damage may already be irreparable. FMH cannot be detected through ultrasounds or routine pregnancy health tests.
  5. FMH happens most frequently to full-term babies. This means that it is more likely to strike pregnant women who are well into the theoretical “safe zone.” Yet
  6.  …it can also happen in the second trimester, meaning it is the equivalent of a biological terrorist that can strike without warning at any time, but most likely when it’s least expected.
  7. And perhaps worst of all, not all cases of FMH are fatal. If the stars align and the baby happens to be delivered and treated in the nick of time, the lucky ones may grow and thrive with minor (if any) health complications or cognitive delays. Since many cases have a more tragic ending, women like myself who lose their babies are condemned to a life of guilt and self-blame for not being able to save them.

Many loss mamas feel rightfully relieved in subsequent pregnancies when they surpass particular milestones. Women who experience early miscarriages may feel safe when they reach the second trimester. Women who received heartbreaking news at their second trimester anatomy scans may feel at ease when their next baby gets a clean bill of health.

But where does that leave women whose first pregnancies result in a full term loss, whether it be to FMH or other unpreventable complications?

I have been told that my chance of experiencing another FMH in subsequent pregnancies is slightly higher now that I have experienced it once, but overall it is very unlikely to occur again. It would be the equivalent of being in a freak highway accident two times over, or winning the world’s worst lottery twice. Unfortunately now that I have been “the statistic” once, I doubt my anxiety will ever let me believe that I can escape a similar tragedy in the future.

In short, Fetomaternal Hemorrhage can go to hell.


Fetomaternal Hemorrhage Can Go to Hell Part 1: Anticipating the Worst

One of the worst things that can happen to someone with Generalized Anxiety Disorder is to see the worst case scenarios they concoct in their minds suddenly become their reality. It’s much easier to talk myself out of an anxiety spiral when I know there is no logical reason or life precedent to justify my catastrophizing. Throw a cocktail of volatile pregnancy hormones into the mix, and suddenly my default anxiety mode borders on explosive.

captain awkward

Image credit via Captain Awkward

Physically speaking, my pregnancy with Leah was on the “easy” end of the spectrum. My first trimester nausea mainly consisted of food aversions, I felt fairly energetic all the way through, and my recurrent acid reflux could be easily remedied by chalky antacid tablets. But the anxiety. I felt one whopping day of pregnancy bliss before the worry kicked in. I knew immediately that I loved the little life that was growing inside me, so of course I immediately began worrying about losing it.

To say that researching everything that can go wrong during pregnancy became my hobby for the next nine months would be an understatement. It was more like a full time job. Ectopic pregnancies. Missed miscarriages. Cervical incompetence. Placental abruptions. Amniotic fluid leaks. Umbilical cord accidents. I knew it all, and I also knew that if these things happened to pregnant women every day somewhere in the world, they could also happen to me.

I did my best to proceed throughout the pregnancy with cautious optimism. After all, as a friend had sardonically remarked, I was the “perfect human incubator”: At 29 I was a young(ish) mother in my ideal weight range with no underlying health issues or harmful addictions. I bought books on using mindfulness techniques to mitigate anxiety and tried my best to take my pregnancy one day at a time. Still, each time I felt the cold touch of a Doppler or ultrasound machine on my swollen belly, I held my breath and silently braced myself for the worst.

I did not allow myself to relax in my pregnancy until I was 36 weeks along. And when I heard my anxiety beckon me back to its side, I would assure myself that, finally, I was statistically more likely to bring a healthy baby home at this point than not.

So I finally let go of the fear. I finally allowed myself to embrace the pregnancy bliss that I had heard other women talk about but never dared allow myself to feel. I began speaking about Leah in terms of “when’s” and not “if’s.” I cooked big batches of meals to freeze and made a Netflix playlist to keep me occupied during late night feedings. I washed baby clothes, installed the car seat, and packed my hospital bag. I was ecstatic. I was ready. 

And then it all went to hell.