The term "rainbow baby" may sound magical, but it is also laced with grief. The phrase has come to be used to describe the birth of a healthy baby after a loss caused by miscarriage, stillbirth or neonatal death. This month, Carrie Johnson, wife of British Prime Minister Boris Johnson, shed light on the topic when announcing she is expecting their second child this winter, after a miscarriage at the start of the year that left her “heartbroken”. “Hoping for our rainbow baby this Christmas,” she said. While the term comes with a wonderfully positive connotation – the idea of a rainbow brightening the sky after a storm, or a pot of gold at the end of a rainbow – the reality is much more complicated. UAE resident Alana Witte Gallini, who had a rainbow baby last year, shared a quote by Jennie Agg, the journalist behind <i>The Uterus Monologues </i>blog, to better sum up the situation. “It sounds simple, implying the bright spell after a storm. But a rainbow is really about conflicting things happening simultaneously – it’s literally sunlight scattered through raindrops. This kind of motherhood, then, is joy refracted through grief.” Gallini’s story will sound familiar to many women. While she and her husband hadn’t planned on starting a family, the minute they saw the positive line on the pregnancy test, they were “over the moon”. “It was my first time being pregnant, and I went into it like a lot of first-time pregnant women would. While I was not naive in thinking that nothing would happen – you hear about miscarriages all the time, you know the stats – you just don’t ever think it will happen to you.” Everything about the pregnancy was straightforward, until Gallini was informed during a routine 20-week scan that something was wrong with the baby’s heart, and that the baby’s development was "incompatible with life". “I think all kinds of baby losses are horrible; there’s so much grief and everyone processes it differently. But it felt doubly cruel that I was supposed to make a choice of how we wanted to proceed,” she says. “We ended up giving birth at 20 weeks. It was traumatic and debilitatingly scary. Even though it’s completely inane, you wonder if you did something wrong. “So when I did fall pregnant again a couple of months later, I wanted to have that beautiful, starry-eyed positive outlook.” The reality was much harder, though. As Dr Kate Prozeller, psychologist and member of the Maternal Mental Health Unit at Thrive Wellbeing Centre, puts it, expecting parents already feel a range of emotions; excitement and joy, with a mix of anxiety or uncertainty about the future. “But for parents expecting a rainbow baby, this mix expands to include uncertainty that they’ll face the loss of another baby,” she says. Lala Langtry White, a doula in the UAE who specialises in supporting women with special circumstances in pregnancy, agrees. “You’ve already learnt that the worst possible thing can happen and that mars the joy you are experiencing with your new pregnancy,” she says. “If you’ve previously had a scan where you’ve been told that your baby has an anomaly that is incompatible with life, then every scan with the new baby can be hugely anxiety-provoking, instead of a bonding experience. Or it can become very reassuring from the moment you’re in it and you’re told everything is normal, but then it can feel like ages until the next scan. It’s a real roller coaster ride of emotions.” Dr Sindhu Ravishankar, specialist in obstetrics and gynaecology at Aster Clinic, Discovery Gardens, reminds parents-to-be that having one miscarriage is no indicator that something will go wrong with the next pregnancy. She says that 80 per cent to 90 per cent of people who fall pregnant after a miscarriage "will have an uneventful pregnancy". "Fewer than 10 per cent can have recurrent miscarriages, that is having three or more consecutive miscarriages.” However, there is no denying that these experiences can cause emotional and physical trauma, with Ravishankar recommending allowing at least three to six months’ time to recover emotionally and physically. “Before planning your next pregnancy, it is better to get preconceptional counselling, where blood tests and scans will be conducted," she says. “Talking to your doctors, and understanding the science and reason behind the miscarriage, would be of some help." Those experiencing recurrent miscarriages can also undergo detailed counselling, to rule out any medical condition. Gallini now has a healthy son, who turned 1 in July. Despite the love she feels for him, she says there are still moments when she is emotionally triggered. “I remember when my husband and I were considering getting pregnant again, I felt guilty – like I was somehow betraying the baby that I lost. It sounds crazy, but you do feel that.” Prozeller says this is common among parents who have experienced loss. “Overcoming grief is not a straight line from sad to happy.” Guilt can occur throughout the pregnancy, says Langtry White. “For a lot of families, particularly with those who become pregnant again within a year or nine months, there is conflicting emotion because they know that this baby would not have been there if their other baby had survived. So there is a level of joy for this new baby, absolutely, but along with so many different complex feelings." These feelings can continue well after the baby is born, she says. “They have this longed-for, healthy baby in their arms, and with it comes questions or lingering thoughts about the previous baby – how similar they would have been." And though the presence of that rainbow baby can be incredibly healing and soothing, “it doesn’t replace the baby you previously had”, she says. “That is something every parent of a rainbow baby would want to be made fundamentally clear. Just because you have a baby in your arms doesn’t take away from the grief of the baby you lost. I don’t think anyone should assume that someone is fixed or healed because they now have a healthy baby.” While pregnant, women are often cautioned to monitor their emotions as “whatever mum is feeling, baby is feeling”. And this, in turn, can lead mums to suppress their emotions, which can inadvertently backfire. Langtry White recommends simply letting such feelings flow freely. “I say to every mum I work with: you are teaching your child emotional intelligence. And that includes some of the tougher emotions – grief, guilt, anger, rage and despair. "Instead, talk to your baby. Say: ‘These are the things I’m feeling today – it doesn’t mean I don’t love you.'" Gallini agrees. “The more I allowed myself to feel negative thoughts, the more I felt like they moved through me quicker. And I could get back to grounding myself with my rainbow baby.” There are several types of grounding techniques experts recommend. Langtry White, who is also a hypnobirthing instructor, advises listing five things you can see, smell and touch, to bring you back into the moment. “Within hypnobirthing, we discuss a lot of breathing techniques. And then there is visualisation – for example, visualising a safe space that makes you feel supported." Tamara Cianfini, founder of the Wise Hippo birthing programme, says there are ways to exchange negative emotions with positive ones. “We look at techniques to keep calm and regain control in case of triggering incidents. One example is the cloak of protection – imagine wrapping yourself up in a protective cloak when negative thoughts creep up.” Finally, experts recommend finding a way to honour the loss of a previous baby. “Some parents have found it therapeutic to plant a tree or flowers, make a special keepsake, perform a balloon release or hold a naming ceremony,” says Prozeller. Cianfini says: "I have a client who still celebrates the birth of the baby she lost, while her rainbow baby has always known about that sibling. It’s not a distant memory, but very much in the present. In that way, she was able to find a positive side to a devastating time. “At the end of the day, it’s all about preparing women for any turn. We don’t know what’s going to happen, we have no crystal ball, but what we can do is build strength, confidence, and stay calm and in control of any situation that might occur." One thing all experts recommend when it comes to dealing with pregnancy loss – and the emotions that come with trying again – is finding a reliable source of support. “This could include family, friends, support groups or talking with a professional therapist who is well-versed in maternal mental health,” says Prozeller. “Also, talk to your medical provider about concerns you have related to prior loss.” According to Gallini, the fact a lot of people don’t want to talk about the issue is part of the problem. “You don’t want to make them uncomfortable, so you end up suppressing those emotions.” She says talking to her sister felt therapeutic, as did writing about her journey and sharing it online. This advice also applies to the spouse, says Langtry White, who explains that men and women deal with pregnancy loss in a different manner, with husbands feeling the need to “be strong for their partner in order to help and support them”. “But they, too, have experienced the loss of a baby, and it can be harder for men to express things. The emotions usually come crashing down a little later on.” Counselling would be helpful in these situations, she says. Meanwhile, friends and family are advised to follow the lead of the expecting parents. “Have an open and honest discussion on how you can support them, what they are comfortable with, and listen," says Langtry White. "Don’t use placations like ‘things will be alright’ because the other person knows that things aren’t always alright. They might also have requests – some parents don’t want baby showers or gifts beforehand. Discuss it with them and respect their wishes.”