A Loss of Innocence and a Gain in Vulnerability: Subsequent Pregnancy after a Loss

and 30,000 newborn deaths. Many of the families who suffer these losses will become pregnant again; however, the crisis of loss and grief responses leave the family feeling more vulnerable to the unexpected during the next pregnancy. For most families, the next pregnancy is fraught with anxiety and fear. Health care professionals need to be aware of these families ’ responses to loss, concerns, and needs for support during the next pregnancy. Therefore, the purpose of this article is to provide an understanding of the impact of early pregnancy loss, perinatal loss, and subsequent pregnancy loss, based on research findings. Interventions, based on the research findings, that health care professionals might use in offering anticipatory guidance, information, and support during this time are also offered. Each year in the United States, there are some 650,000 miscarriages, 30,000 stillbirths, and 30,000 newborn deaths (Cunningham, MacDon-ald, and Gant 1997). For many of the couples who experience these losses, a miscarriage, stillbirth, or newborn death is their first experience with a life crisis of this magnitude. Their grief knocks them to their knees, and as they struggle to regain some normalcy in their life, they realize they have experienced more than the loss of a pregnancy and/or baby—they have also experienced a loss of innocence. Many of these families will become pregnant again. The next pregnancy can bring a new vulnerabil-ity fraught with fears and anxiety because the family now has to contend with such thoughts as “Will it happen again? ” “Can I let myself love another baby? ” and “Am I really ready for this? ” The purpose of thi