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How to cope with pregnancy loss


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    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

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Why is it so important for us to talk about the loss of a child

Why is it so important for us to talk about the loss of a child?
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    • Why is it so important for us to talk about the loss of a child

    Why is it important for us to talk about the loss of a child

    WHO/M. Purdie

    © Photo

    The loss of a child during pregnancy due to miscarriage or stillbirth is still a taboo subject around the world, with condemnation or shame associated with it. Many women who lose a child during pregnancy or childbirth continue to receive neither the proper care nor the respect they deserve. nine0291 In this material we want to share stories told by women from different countries.

    Miscarriage is the most common cause of pregnancy loss. Estimates of the prevalence of this phenomenon vary somewhat, although according to the March of Dimes Foundation, an organization dedicated to maternal and child health, the prevalence of miscarriage in women who knew they were pregnant is 10-15%. Different countries around the world use different definitions of pregnancy loss, but as a rule, the death of a child before 28 weeks of gestation is considered a miscarriage, and death at or after 28 completed gestational weeks is considered a stillbirth. There are 2.6 million stillborn babies born each year, and many of these deaths could have been prevented. However, even in developed countries, miscarriages and stillbirths are not systematically recorded, so the actual figures may be even higher. nine0283

    Worldwide, women's access to health services varies by country of residence, with hospitals and outpatient facilities very often under-resourced and staffed in many countries. As varied as the experiences of women who have lost a child may be, stigma, guilt and shame are common themes around the world. As personal experiences shared by women who have lost their children show, they felt that they should keep their grief quiet, either because miscarriage or stillbirth remains common, or because people perceive it as something inevitable. nine0283

    Jessica Zucker, Clinical Psychologist and Writer, USA

    “I am a clinical psychologist specializing in mental health issues related to reproduction and motherhood. I have been doing this for over ten years. But when I myself had a miscarriage at 16 weeks, only then could I truly feel that heartache, that re-experienced feeling of grief and loss that my patients have been telling me about for so many years.

    Jessica's story

    All this has an extremely hard effect on women. Many women who lose a child during pregnancy may develop mental health problems that last for months or years, even if they later have healthy children.

    Cultural and social views on the loss of a child in different parts of the world can be very different from each other. Thus, in sub-Saharan Africa, the prevailing opinion is that a baby can be born dead because of witchcraft or the machinations of evil spirits. nine0149

    Larai, 44, pharmacist, Nigeria

    “I took everything that happened after my miscarriage very hard. This was greatly facilitated by the medical workers themselves, despite the fact that I am also a doctor. Another issue is cultural representations. Here, the loss of a child brings shame to the woman, because there is a perception that if a woman has lost a child several times, something is wrong with her, and that she may have had extramarital affairs, and the loss of a child in that case, God's punishment. nine0283

    Larai's story

    There are many possible causes for miscarriages or stillbirths, including fetal abnormalities, maternal age, and infections, many of which (such as malaria and syphilis) are preventable, although identifying the exact cause is often difficult.

    General recommendations for preventing miscarriage include a healthy diet, physical activity, avoiding smoking, drug and alcohol use, limiting caffeine intake, managing stress, and maintaining a normal body weight. This approach focuses on lifestyle factors, and in the absence of specific explanations for what happened, this can lead to women feeling guilty that it was their behavior that caused the miscarriage. nine0283

    Lisa, 40, Marketing Manager, UK

    “I've had four miscarriages. Every time this happens, a part of you dies. The first time was the hardest. It was my very first pregnancy. We were so happy that we will soon have a baby. But when we went to our local hospital in the southeast of England at week 12 for a routine ultrasound, I was told that I had a miscarriage, or miscarriage, which meant that my baby had died long ago, although I did not feel no signs. " nine0283

    Lisa's story

    As with some other medical topics, such as mental health, which remain a huge taboo, many women report that, regardless of their cultural background, education and upbringing, their friends and families don't want to talk about their loss. Apparently, this is due to the general tradition to surround any grief with a veil of silence.

    Susan, 34, writer, USA

    “My infertility battle has been going on for almost five years now. After I decided to try IVF, I actually managed to get pregnant, but after a few weeks the baby stopped growing. It took doctors two and a half weeks to confirm this. It took another two weeks before I had a miscarriage that lasted 19days. I could not imagine that it could be so painful, for so long and with such heavy bleeding.

    Susan's story

    Stillbirths occur later in pregnancy, namely after 28 gestational weeks, as defined by WHO. About 98% of stillbirths occur in low- and middle-income countries. Lack of proper care and supervision during labor results in one in two stillbirths occurring during labor, many of which could have been prevented with quality care and proper supervision of the woman in labour. nine0283

    Better care during pregnancy and childbirth could prevent more than half a million stillbirths globally. Even in high-income countries, non-compliance with standards of care is an important cause of stillbirths.

    There are clear ways to reduce the number of children who die during pregnancy, namely: improving access to antenatal care (in some parts of the world, women do not see a health worker until they are several months pregnant), introducing continuous care models, provided by midwives, as well as community care where possible. Integrating infection management during pregnancy, fetal heart rate monitoring and birth monitoring into a comprehensive care package could save 1.3 million lives of otherwise stillborn babies. nine0283

    Emilia, 36, shopkeeper, Colombia

    “When my baby was stillborn at 32 weeks, we already gave him a name. The doctor sent me for an ultrasound examination, during which he told me that the baby was not showing signs of life. I knew right away that my baby was dead. I know this could have been avoided. If from the very beginning I had been told everything about my condition in more detail, if the doctors had treated me more attentively during the critical periods of my pregnancy, my child could have been saved. nine0283

    Emilia's story

    Attitude towards women during pregnancy is related to the extent to which their sexual and reproductive rights are generally realized; many women around the world do not have the ability to make autonomous decisions in this area.

    In many parts of the world, the pressure of public opinion is forcing women to become pregnant when they are not yet physically or psychologically ready for it. Even in 2019, 200 million women who want to avoid pregnancy do not have access to modern methods of contraception. And when pregnancy does occur, 30 million women are forced to give birth outside of health facilities, and 45 million women do not receive adequate antenatal care or no antenatal care at all, greatly increasing the risk of complications and death for both the mother and the mother. child. nine0283

    Cultural practices, such as ritual female genital mutilation and child marriage, cause great harm to girls' sexual and reproductive health and the health of their children. Having children at a young age can be dangerous for both mother and child. Adolescent girls (aged 10–19 years) are significantly more likely to have eclampsia or intrauterine infections than women aged 20–24 years, increasing the risk of stillbirth in this age group. In addition, babies born to women younger than 20 are more likely to have low birth weight, prematurity, or severe health problems in the first month of life, which also increases the risk of stillbirth. nine0283

    Female genital mutilation increases a woman's risk of protracted or difficult labour, bleeding, severe tears and increases the frequency of instrumental use in childbirth. At the same time, children of such mothers are much more likely to need resuscitation during childbirth and increase the risk of death during childbirth or after birth.

    Putting women at the center of care is critical to creating a positive pregnancy experience—the biomedical and physiological aspects of health services need to be complemented by social, cultural, emotional and psychological support. nine0283

    However, many women, even in developed countries with access to the best health care systems, do not receive adequate care after the loss of a child. Even the language used by medical professionals in relation to miscarriage and stillbirth can be traumatic in itself: the use of terms such as "cervical failure" or "dead gestational sac" can be painful.

    Andrea, 28, stylist and singer, Colombia

    “When I was 12 weeks pregnant, I went to a scheduled appointment with the doctor, where I had an ultrasound. The doctor told me that I was not doing well, but did not specify what exactly was wrong. The next day, when I woke up, I noticed blood stains on the sheets. I didn't get any information about why I had a miscarriage. My doctor was very kind to me, but he didn't explain anything to me. But the nurses were completely indifferent and unfriendly and behaved as if I had undergone an ordinary medical procedure, and nothing more. No one gave me any support." nine0283

    Depending on the rules of the particular medical facility, stillborn bodies may be treated as clinical waste and may be incinerated. It happens that when a woman learns that her child has died, she is forced to continue to carry the dead baby for several weeks before she can give birth. Even if this delay may be clinically justified, this situation is excruciating for both the woman and her partner. Even in developed countries, women may be forced to give birth to their dead babies in maternity wards, surrounded by women who have healthy children, which is very difficult from a psychological point of view and reminds the woman of her loss. nine0283

    Not all inpatient or outpatient facilities can adopt a new care strategy or provide more services. This is the reality that reflects the overload of health systems. And yet, there is no extra cost to be more sensitive in dealing with bereaved couples and to remove the taboo and stigma around talking about the loss of a child. This is evidenced by some of the stories told here.

    Medical staff are fully capable of being sensitive and compassionate, recognizing the depth of the parents' feelings, providing clear information about the situation, and understanding that parents may need special support, both in relation to the loss of a child and in relation to the possible desire for more children. . To provide competent maternal and newborn health care and to meet the requirements for clinical competence in general, it is necessary that this care be provided from a human rights perspective, on the basis of respect, protecting the dignity of patients and taking into account their socio-cultural characteristics. nine0283

    Learn more about the work of WHO

    Learn more about the work of WHO in collaboration with partner organizations

    How to survive a missed pregnancy and perinatal loss

    It is customary for women who have experienced this to console themselves with the fact that there will still be in their lives - both a new pregnancy and a new child . .. But they first of all need something else: the right to “legally » mourn your unborn child. The right to feel like his mother too. Two women shared their stories — and how their loved ones reacted to them. nine0283

    New hearth

    Alexandra: “I was able to hold him in my hands”

    Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

    Our second baby was due in June of this year. When the eldest, Nastenka, was one and a half years old, we decided that we were ready for a second child. We have been waiting for a positive test for almost a year, and now - hooray! two stripes! nine0283

    It was autumn, and already in the fifth week I got sick with sinusitis so that I had to take antibiotics. At this time, I read a lot of pregnancy forums and hoped that this would not harm my baby. But since then it has become unsettled. At 7 weeks I went for an ultrasound, to listen to the heart - they did not hear. I was asked to come back in a week. I was very worried, but then both my husband and all my friends set me up for the good, and I decided to wait for the planned ultrasound at 12 weeks.

    At 10 weeks I started bleeding, I went to the hospital. The ultrasound confirmed the missed pregnancy. In the ward for five, I cried quietly. I could not afford tears during pregnancy. Three girls were in storage. The fourth was a 40-year-old woman with a miscarriage. She told me then: “You will give birth again, young!” nine0283

    We took abortion pills with her. After the very first pill, by the evening there was blood. It poured non-stop, the pressure dropped a lot, but it was impossible to lie down. Everyone supported me, the nurse and that woman from the ward accompanied me on the bidet, walked with me along the corridor so that I would not fall, brought tea.

    After 3 hours the fetus came out - my child! I held it in my hands, but didn’t cry, probably, I just didn’t have the strength. I gave it to my husband, and we decided that as soon as I left the hospital, we would go to the cemetery together and put it in the ground. nine0283

    How did my mother feel about what happened? She said that this was a “bell” for me, and I should devote more time to Nastya and not go to work until her third birthday ...

    I burst into tears then in the hospital, I wanted support, some other words.

    The girls from the ward began to ask what happened, we started talking, and it turned out that one mother told to have an abortion with a third pregnancy, and the other - just to kill the second child, because toxicosis, because diseases interfere and it's hard to walk! nine0283

    Did I blame myself? Yes. I know for sure that I could not influence my illness and change something: immunity in the first weeks of pregnancy is always very weakened. At the same time, it seems to me that if I had led a more correct life, had been more attentive, then this would not have happened ... All the time this internal dialogue. I believe in God, in His Providence in the life of every person, and I am learning to thank Him not only for joys, but also for trials.

    What helped me then? It's terrible when you want to scream about your grief, but you don't scream because you're afraid! I immediately began to call those who experienced it. I called my friend, I called a relative who also lost her babies during pregnancy. Their words were support for me. nine0283

    Those friends who did not survive such a loss also consoled me, but their words hurt me a little. These are, for example, the words that he could have been born sick, and then it would have been worse... But is it great to lose a child? While I was in the hospital, I remembered my first birth, when I left the hospital and I thought: “Wow! Women who have survived childbirth, this pain is the heroine! And now - I was lying after a miscarriage and thought that women who survived the death of their child are the real heroines. nine0283

    It is customary for us to share joyful moments with friends, post happy family photos on social networks, and here you are alone with your grief.

    Then, on the page of one girl, I found information about the Light in Hands Foundation. This girl was not afraid to talk about her loss, but I'm still afraid... On the foundation's website, I read the stories of women who survived the death of their babies, cried, and it became easier for me, because I'm not alone, because many women survived this we just don't know about it. I didn’t manage to cry in the hospital, but it was so good at home - my husband and daughter were nearby. I didn’t sob uncontrollably, just looking at Nastya, I imagined that this is how my baby would grow up, but he is no more... And tears rolled up. nine0283

    On the weekend, my husband and I went to the cemetery, to the graves of his relatives. There, in the grave of great-grandmother Alexandra, my namesake, we buried our little box. I was glad that my baby was in the ground. Thank God that he came out so that I could see him, hold him in my hands, and bury him. We do not know who we had - a boy or a girl, we did not give the fetus for analysis. They just came up with names - both male and female - Zhenya or Anya.

    I am now pregnant, we are 16 weeks old and I could hear my baby's heartbeat. For me, this pregnancy is a miracle and hope. It's a miracle that only four months have passed, and again a baby lives inside me. The only pity is that during this time I have not become better. I could seem to help someone, but I still spin only around myself. I think that God sent us that loss so that we often look back at the misfortunes of the people around us, help them. nine0283

    In the last pregnancy, we immediately told everyone our good news. This time, we told our relatives only closer to 12 weeks, at work I don’t tell until they ask. For some reason, I am embarrassed that I am pregnant, I want to hide this miracle from prying eyes, conversations and congratulations for a longer time. And my husband also hopes that after the birth of my second child I will change my mind: I still dream that we will have many children.

    Read also: What to say to a mother who has lost a child in childbirth

    In this pregnancy, of course, more anxious. The word “scary” probably doesn’t fit here: it’s very exciting, joyful, and you experience more than usual, especially when you hear a heartbeat for the first time... During my first pregnancy, I didn’t think about anything, I only went to the second ultrasound find out the gender of the baby. I could not even imagine that it is possible to be pregnant and not give birth. Now every trip to the doctor is worries about the baby’s health, a swarm of thoughts in my head: what if he is sick, suddenly something is wrong with him... I reassure myself that everything will be according to God’s will, everything is for our benefit, do not run away from something, but simply trust Him. nine0283

    Children born after pregnancy loss are called rainbow children. It seems to me that this is a very correct name.

    Just as after the Flood God sent a rainbow as a sign that water would no longer destroy everything on earth, so the rainbow baby is a hope that all bad things are behind, and ahead is happiness and life.

    Natalya: “Are you scared? Highly. Hurt? Unbearable”

    My name is Natalia. I am a graphic designer and artist, and I am also a volunteer for the Light in Hands charity foundation. Our team provides free psychological assistance to parents in case of perinatal losses, and also works with the medical staff of maternity hospitals, conducting trainings to prevent professional burnout and to promote an ethical attitude towards women in labor. In the fund, I organize support groups in St. Petersburg and Chelyabinsk, as well as various actions within the framework of the fund’s activities and promote the fund in the regions. nine0283

    Like many others, a personal tragedy brought me to the foundation.

    In 2014, at 20 weeks, I lost my first child, and in July 2015 I learned from my own experience that children are born not only alive, but also a lot more about the term "antenatal fetal death". So in official medicine, intrauterine death of babies is called. But in fact, this is the strongest psychological trauma, which not everyone can recover from. I found out about the death of my daughter when I came to give birth in a maternity hospital with contractions. Scary? Highly. Hurt? Unbearable. This is a huge burden of pain that falls on any mother who faces this. The gestational age at which the loss occurred has no effect. A 6-week miscarriage and a stillbirth in the same way leave a huge scar in the heart of every woman. nine0283

    Either my previous experience, or my circle of friends, in which there are many psychologists, or relatives and friends who supported me during this period of time, or maybe all together, helped me get out and live on, based on this experience. When I restored my resources, I realized that I want to change a lot in this area, in this world, in the minds of people. So I started looking for this opportunity and joined the foundation team.

    At each support group that we hold 2 times a month, I sit in the circle of parents as equals. Every time I tell my story, every time I live it in a new way. I pass through myself the pain of each participant, each tragedy. We share this pain with everyone, and it becomes less. Each person's experience is a valuable resource. nine0283

    I've heard dozens of stories, I've seen a lot of pain, but every story is a love story. A mother's love for her child.

    Any person who has survived a tragedy tries to seek understanding among his own kind. We are orphaned parents, very often we close ourselves off from the world, relatives and friends, believing that our tragedy is only ours. And no one will understand us, accept us, or hear us. But is it?

    One of the stories I heard at the support group pushed me to the idea of ​​conducting a small survey among my close people and acquaintances. Some of them were among the first to know about my tragedy, some a little later, and I met some relatively recently. I sent out a message to a little more than a dozen people. I am very grateful to those who responded. nine0283

    The content was as follows: “What feelings and emotions did you experience when you found out about my loss (in the sense of a child)? What were your first thoughts?

    Below I will give their answers.

    Olga B. “Hello, my dear! Pain, sympathy, I wanted to hug. I didn’t know how to help, whether it was worth talking to you about this topic - because I didn’t know how I could help. "

    Irina M. and also the fear of somehow hurting you, saying something wrong. And not knowing how to support you, how to express participation and empathy. The thought that if I were in your place, the soil would leave -under the feet, and the thought "please save"

    Olga G. “The first feeling was confusion, emptiness... How? Then she remembered herself. Then it returned to its previous state. I understood how you feel. I wanted to help, but I understood that it was pointless... In the first minutes no one is needed....”

    Irina K. “I felt pain, fear, horror. I looked at you and thought what was wrong with you. How can you survive this?!"

    Irina S. "Under the impression of your story, I did not buy any things for the child in advance. I bought it only for the maternity hospital. Then my husband, like a scalded man, ran to buy things, a crib, diapers, etc. for discharge. I constantly had your story in my thoughts. Plus, the pregnancy proceeded with minor complications. Then they had a lack of oxygen, then the neck was short. My husband's sister gave me baby things. I didn't take it until I gave birth. "I took your grief very seriously. At the very least, there is a sense of embarrassment." nine0283

    I received this feedback after a post on social media when I first spoke publicly about my loss.

    Nadezhda O. (older sister) “Hi dear! The first thing in my head was; how did you yourself, you were very worried about you, it was not digested in your head how this could happen and why?! It was hard to understand everything. It was a pity for the little one and for you! I cried when my dad told me about this and sincerely worried about your loss!”

    Olga S. “Hello, a difficult question of course... I don’t even know, probably fear, I thought about how scary it is to lose the most precious thing, because I myself just became a mother. And then I wanted to cry when I put myself in your place, cry from pain. Damn, it's hard...”

    Inna M. “I was very worried, upset for you, and very angry with the doctors, and remembered you, I thought often.”

    Irina M. “You know, when I was not a mother, I perceived it differently. Yes, trouble, but not the end of the world. Abortions were also perceived easier for girls. And now this.. Anxiety. I was acutely worried about A., and your losses cause even more emotion, because more than once. It's hard to pick up words in such cases. I don’t want to become discouraged, therefore sometimes phrases like “it will still be, don’t be upset” are heard, although everyone will say it. We are probably afraid at such moments. We are afraid to accept all the cruelty of the case. But I live in a pink world and I believe that the happiness of motherhood will come to every such girl.” nine0283

    Vitaliy T. "It was painful to learn about this.... Moreover, you deserve the happiness of motherhood like no one else..." and compassion came with the second wave. And the first one is still a shock.”

    Such feedback was a shocking discovery for me. After all, until that time I lived in "happy" ignorance that my grief was only mine. But it turned out that dozens of people share it. It had an irreversible impact on the lives of many, I wanted to or not.

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