How to lose your baby

Options for Unwanted Pregnancy

Unwanted pregnancy isn’t uncommon. Almost half of all pregnancies in the United States are unintended, according to a 2016 study.

If you become pregnant and you’re either not ready to be a parent or you don’t want to have a baby, know that you’re not alone and you do have options.

You can choose to terminate the pregnancy with an abortion or put your baby up for adoption. It’s a big choice and one that can feel overwhelming.

Remember, the “right” decision is the one that’s healthiest for you, and only you can determine that.

If you know you don’t want to have a baby but are unsure of what to do next, it’s OK to ask for help. Your spouse, partner, friends, other supportive family members, or a therapist can help talk you through the decision.

A doctor can also help guide you through this process and recommend appropriate resources.

Abortion is a procedure that terminates a pregnancy. Most abortions are performed during the first trimester, or first 12 weeks of a pregnancy.

This procedure is legal in the United States, but restrictions vary from state to state. In some states, parental consent is required for people under age 18.

Finding a provider

Doctors, abortion clinics, and Planned Parenthood centers all provide abortions. Although abortion is legal in every state, some states have fewer providers than others.

To find a clinic near you, ask your primary care doctor or obstetrician/gynecologist to refer you to a doctor who performs abortions. Or, look through a directory of providers offered by an organization like Planned Parenthood or the National Abortion Federation.

When you visit the clinic, make sure there are doctors on staff. Some clinics offer free pregnancy tests or ultrasounds, but they don’t actually perform abortions. These facilities may call themselves “crisis pregnancy centers.”

Here are a few questions to ask the doctor or hospital/clinic staff:

What type(s) of abortion can I have?
How much will it cost? Are all medications and follow-up visits included in the fee?
Will insurance cover any of the costs?
Do you provide counseling before and after the abortion?
What types of medical training do your doctors have?
For a medical abortion, do you provide additional medications for pain and nausea relief?
For a surgical abortion, what kinds of anesthesia will you use, and who administers it?
How long will the procedure take? Can it be done in one visit? If not, how many visits are required?
What will you do in case of an emergency?
Will the clinic provide follow-up medical care after my abortion?

Costs

Abortion costs range from $300 to $800 for a medical abortion, up to $1,000 or more for a surgical abortion.

The cost depends on where you have the procedure and how far along you are in your pregnancy. A second-trimester abortion in a hospital is more expensive than a first-trimester abortion in a clinic.

Some health insurance providers cover abortion costs. Call your provider to find out what they’ll cover. Medicaid and other government insurance plans also might pay some or all of the costs.

A few different types of abortion are available.

During a surgical abortion, a doctor uses suction to remove the fetus and placenta. With a medical abortion, or the abortion pill, you’ll take a combination of drugs to end the pregnancy.

The method you choose depends on your preferences and how far along you are in your pregnancy. Surgical abortions can be performed in the first and early second trimesters of pregnancy. The abortion pill can be used until the 10th week of pregnancy.

Surgical abortion

There are two types of surgical abortion:

vacuum aspiration abortion
dilation and evacuation (D&E) abortion

Vacuum aspiration is done during the first trimester or early second trimester of pregnancy. After you’re given medication to numb your cervix and prevent pain, the doctor will insert a tube through your cervix into your uterus. Suction is then used to pull the fetus and placenta out of the uterus.

In a D&E abortion, the cervix is first numbed with a local anesthetic. Then, a dilator opens the cervix. A thin tube is inserted into the uterus through the cervix. The tube is attached to a suction machine that removes the contents of the uterus.

Surgical abortions are safe and normally take no longer than 10 to 20 minutes. You can go home on the same day the procedure is done.

You may have some cramping after an abortion. You shouldn’t have sex or insert a tampon for up to two weeks to let the uterus heal. Heavy menstrual-like bleeding and blood clots are common.

The clinic will give specific instructions about the amount of bleeding and how long it may last. They may also recommend scheduling a follow-up appointment, either at the clinic or with your gynecologist.

Abortion pill

The abortion pill is also known as a medical abortion. This method uses two pills — mifepristone (Mifeprex) and misoprostal (Cytotec) — to end a pregnancy.

A drug-induced abortion can be done up to your 10th week of pregnancy. Mifeprex works by blocking the hormone progesterone. Without this hormone, the embryo can’t implant in the uterus and grow.

You take Cytotec a few hours or up to four days after Mifeprex. It makes your uterus contract to push out the pregnancy tissue.

It’s normal to have side effects like bleeding and cramping after an abortion. The provider that performed your abortion should offer follow-up care for these side effects. An ultrasound is usually performed afterward to ensure the abortion is complete.

Even if the pregnancy is unwanted, the experience of having an abortion may be emotional. If you feel depressed or anxious, talk to a mental health provider or social worker.

You can also reach out to these organizations for support after an abortion:

All-Options
Exhale
Project Voice

If you aren’t comfortable with the idea of having an abortion, you can put your baby up for adoption. A public or private adoption agency can help you find a family who’ll raise your child in the way that you’d want. Some agencies will even pay your medical and legal costs.

An independent adoption is done directly between you and the adoptive parents. The parents might be your relatives, friends, or people you’ve found through a trusted source such as an attorney or social worker.

Some states don’t allow independent adoptions. If they’re legal in your state, an attorney can help you with the paperwork.

Types of adoption

Adoptions can be closed or open.

A closed adoption means you’ll have no contact with the adoptive family in the future. Once the adoption has been finalized, the records are sealed. Your child may have access to these records when they turn 18.

An open adoption allows you to have some contact with the adoptive family. That contact can range from letters and phone calls to visits with your child.

How to find an adoption agency

Finding a reputable adoption agency will help ensure that your baby goes to the best possible family. You can start by asking an adoption lawyer or social worker for a referral. Or, do a search through an organization like the National Council for Adoption.

To make sure the agency is reputable, contact your state’s licensing specialist and Better Business Bureau to see if any complaints have been filed against them. Also contact the state’s attorney general’s office and ask if any legal action has been taken against the agency.

Finally, ask the adoption agency for at least three references from clients who’ve been through the adoption process.

The agency you choose should counsel you on your decision but never pressure you. You should never have to pay the agency for counseling or adoption services.

Questions to ask the agency

Here are a few questions to ask any adoption agencies you’re considering:

What state adoption laws do you have to follow? Does your state check to make sure you’re complying with those laws?
How many staff members do you have?
Is someone available 24 hours a day, 7 days a week?
What kind of counseling services do you offer?
How much input will I have in choosing an adoptive family for my child?
Are there any costs involved in putting my child up for adoption?
Will you cover any of my medical or legal costs?
What kinds of services will you provide after my child is placed with a family?
Will you help me communicate with my child in the future?

Deciding how to handle an unwanted pregnancy can be an emotional experience. Everyone’s circumstances are different, so do what feels right for you and your situation. The choice is ultimately yours.

Having a strong support network and good medical advice can help make the decision easier. It’s also important to feel comfortable with the abortion provider or adoptive agency you select, so don’t be afraid to ask lots of questions about a procedure, process, or facility.

No matter which option you choose, make sure you take time for self-care afterward. It can be helpful to talk with a social worker or therapist in order to process emotions that arise.

Options for Unwanted Pregnancy

Unwanted pregnancy isn’t uncommon. Almost half of all pregnancies in the United States are unintended, according to a 2016 study.

If you become pregnant and you’re either not ready to be a parent or you don’t want to have a baby, know that you’re not alone and you do have options.

You can choose to terminate the pregnancy with an abortion or put your baby up for adoption. It’s a big choice and one that can feel overwhelming.

Remember, the “right” decision is the one that’s healthiest for you, and only you can determine that.

A doctor can also help guide you through this process and recommend appropriate resources.

Abortion is a procedure that terminates a pregnancy. Most abortions are performed during the first trimester, or first 12 weeks of a pregnancy.

This procedure is legal in the United States, but restrictions vary from state to state. In some states, parental consent is required for people under age 18.

Finding a provider

Doctors, abortion clinics, and Planned Parenthood centers all provide abortions. Although abortion is legal in every state, some states have fewer providers than others.

Here are a few questions to ask the doctor or hospital/clinic staff:

What type(s) of abortion can I have?
How much will it cost? Are all medications and follow-up visits included in the fee?
Will insurance cover any of the costs?
Do you provide counseling before and after the abortion?
What types of medical training do your doctors have?
For a medical abortion, do you provide additional medications for pain and nausea relief?
For a surgical abortion, what kinds of anesthesia will you use, and who administers it?
How long will the procedure take? Can it be done in one visit? If not, how many visits are required?
What will you do in case of an emergency?
Will the clinic provide follow-up medical care after my abortion?

Costs

Abortion costs range from $300 to $800 for a medical abortion, up to $1,000 or more for a surgical abortion.

The cost depends on where you have the procedure and how far along you are in your pregnancy. A second-trimester abortion in a hospital is more expensive than a first-trimester abortion in a clinic.

Some health insurance providers cover abortion costs. Call your provider to find out what they’ll cover. Medicaid and other government insurance plans also might pay some or all of the costs.

A few different types of abortion are available.

During a surgical abortion, a doctor uses suction to remove the fetus and placenta. With a medical abortion, or the abortion pill, you’ll take a combination of drugs to end the pregnancy.

Surgical abortion

There are two types of surgical abortion:

vacuum aspiration abortion
dilation and evacuation (D&E) abortion

Surgical abortions are safe and normally take no longer than 10 to 20 minutes. You can go home on the same day the procedure is done.

You may have some cramping after an abortion. You shouldn’t have sex or insert a tampon for up to two weeks to let the uterus heal. Heavy menstrual-like bleeding and blood clots are common.

Abortion pill

The abortion pill is also known as a medical abortion. This method uses two pills — mifepristone (Mifeprex) and misoprostal (Cytotec) — to end a pregnancy.

A drug-induced abortion can be done up to your 10th week of pregnancy. Mifeprex works by blocking the hormone progesterone. Without this hormone, the embryo can’t implant in the uterus and grow.

You take Cytotec a few hours or up to four days after Mifeprex. It makes your uterus contract to push out the pregnancy tissue.

Even if the pregnancy is unwanted, the experience of having an abortion may be emotional. If you feel depressed or anxious, talk to a mental health provider or social worker.

You can also reach out to these organizations for support after an abortion:

All-Options
Exhale
Project Voice

Some states don’t allow independent adoptions. If they’re legal in your state, an attorney can help you with the paperwork.

Types of adoption

Adoptions can be closed or open.

An open adoption allows you to have some contact with the adoptive family. That contact can range from letters and phone calls to visits with your child.

How to find an adoption agency

Finally, ask the adoption agency for at least three references from clients who’ve been through the adoption process.

The agency you choose should counsel you on your decision but never pressure you. You should never have to pay the agency for counseling or adoption services.

Questions to ask the agency

Here are a few questions to ask any adoption agencies you’re considering:

What state adoption laws do you have to follow? Does your state check to make sure you’re complying with those laws?
How many staff members do you have?
Is someone available 24 hours a day, 7 days a week?
What kind of counseling services do you offer?
How much input will I have in choosing an adoptive family for my child?
Are there any costs involved in putting my child up for adoption?
Will you cover any of my medical or legal costs?
What kinds of services will you provide after my child is placed with a family?
Will you help me communicate with my child in the future?

No matter which option you choose, make sure you take time for self-care afterward. It can be helpful to talk with a social worker or therapist in order to process emotions that arise.

Miscarriage, how to avoid - Planning and management of pregnancy in the gynecology of the Literary Fund polyclinic after a miscarriage

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A miscarriage is always associated with severe consequences for the whole body of a woman and for her reproductive organs in particular, it also affects the family situation, disrupts the woman's work schedule. An unfavorable outcome of pregnancy requires great mental and physical costs on the part of parents. Therefore, contacting doctors to find out the causes of the problem is the very first and correct step towards the birth of a child.

Any competent gynecologist will tell you that the problem of miscarriage can be solved. With proper preparation for pregnancy and its management, the next time you will have a successful pregnancy. Most girls after a miscarriage go to extremes: they try to get pregnant again as soon as possible. And if this succeeds, then the miscarriage is very often repeated. And you need to give the body a rest for 2-3 months, then identify and eliminate the cause. And only then try.

Causes of miscarriage

Many are convinced that miscarriages are due to a fall, bruise, or some other physical shock. Any woman who has had a miscarriage can remember that not long before she either fell or lifted something heavy. And I am sure that she lost her unborn child precisely because of this. However, those women whose pregnancy was normal also fall and lift heavy things. Most sudden miscarriages do not occur for this reason. The reason is in violations of the pregnancy itself. Approximately half of miscarriages are due to abnormal genetic development of the fetus, which can be hereditary or accidental. Merciful nature, following the principles of natural selection in everything, destroys the defective and unviable fetus. But you should not be afraid of this. The fact that there is a defect in one embryo does not mean at all that all the others will be the same.

The woman's body is almost always to blame for the other half of miscarriages. They are caused by various known and unknown factors, such as: acute infectious diseases suffered in the first trimester of pregnancy, poor environment or difficult working conditions, excessive psychological or physical stress, abnormal development of the uterus, radiation, alcohol, smoking and certain types of drugs.

The causes of early and late miscarriage may differ, although they may overlap. The most important thing is to find out and eliminate or compensate for your own cause of miscarriage. Having discovered the cause, the gynecologist will tell you how to avoid another loss.

Miscarriage

Miscarriage statistics also include “missed pregnancy”. Sometimes it happens that the embryo dies and lingers in the uterine cavity. Most often, this fact is detected by ultrasound. The dead fetus may begin to decompose, and this, thereby, will lead to poisoning of the mother's body.

Doctors resort to surgical curettage, which is associated with a risk of inflammation and complications. With such a miscarriage, the next pregnancy is planned after the body is fully restored - not earlier than a year. During this year, you will have to find out the cause of the missed pregnancy and treat it.

Miscarriage up to 6 weeks

The main causes of miscarriage on this line are malformations of the embryo itself. Statistics say that from 70-90% of embryos had chromosomal abnormalities: they are random and will not occur in other pregnancies. You may have been ill, taken medication, or were under the influence of other harmful factors. Fate saved you from a child with malformations.

The human body is perfect and finds a way to correct the situation by miscarriage. Today is a tragedy for you. The real tragedy would be the preservation and birth of a sick, non-viable child. So don’t cry and understand: everything is for the best, you won’t help grief with tears ... And after three months, try again - it will almost certainly turn out to be successful.

It should also be noted that the fact of a miscarriage does not mean that you have lost something. So for a period of 7-8 weeks, the absence of an embryo in the fetal egg is found - "anembryony". It is believed that in 80-90% of cases, miscarriages are undiagnosed non-developing pregnancies.

Miscarriage between 6 and 12 weeks

Miscarriage in this period is also considered early. Its most common causes are:

Endocrine disorders

Endocrine disorders, when the ovaries do not synthesize enough hormones to keep the fetus in the womb, or the amount of male sex hormones is increased, is one of the most common causes of miscarriage and miscarriage.

Imbalance of hormones in a woman's body is very likely to lead to an early termination of pregnancy. With a lack of the main hormone progesterone produced by the ovaries, this happens most often. Another hormonal problem is an increase in the tone of the uterus, which provokes the expulsion of the fetus.

Progesterone prepares the uterine mucosa for implantation and is the hormone for maintaining pregnancy in the first months. If conception occurs, the fetus cannot properly establish itself in the uterus. As a result, the fertilized egg is rejected. But pregnancy can be saved with the help of progesterone preparations if this problem is detected in time.

An excess of male sex hormones that suppress the production of estrogen and progesterone can also be the cause of an early miscarriage. Often, the cause of recurrent miscarriages are androgens that affect the formation and development of pregnancy; as well as thyroid and adrenal hormones. Therefore, a change in the function of these glands can lead to miscarriage.

Undertreated sexual infections

This problem must be solved before conception. Often the cause of miscarriage is sexually transmitted infections: syphilis, trichomoniasis, toxoplasmosis, chlamydia, cytomegalovirus and herpetic infections. Their effect on the fetus and the course of pregnancy is different for each woman and depends on the timing of infection, the activity of the microorganism, the degree of immune protection and the presence of other adverse factors. Depending on the situation, they can lead to the formation of fetal malformations, intrauterine infection, feto-placental insufficiency, early miscarriage or premature birth. Infection of the fetus and damage to the membrane of the fetus leads to miscarriage. To avoid this, infections should be treated before pregnancy. The use of therapy is possible during pregnancy as prescribed by a doctor.

Viral infections and other diseases

Any disease accompanied by intoxication and fever above 38 ^about C can lead to a miscarriage. Rubella, influenza and viral hepatitis occupy a leading position in this list. At a period of 4-10 weeks for pregnancy, ordinary tonsillitis can also become tragic, pneumonia carries a more serious risk. Pyelonephritis and appendicitis can cause early labor. When planning a pregnancy, it is imperative to undergo a medical examination in order to identify and treat foci of infections.

Extremely dangerous during pregnancy rubella - it leads to severe fetal malformations, so infection during pregnancy is an indication for medical abortion.

Any disease during pregnancy can lead to non-viability of the fetus. And the body, through a miscarriage, insures you against unwanted offspring. With such a miscarriage, the next pregnancy has every chance of going well.

Immune causes of miscarriage

Sometimes antibodies that are hostile to the fetus are formed in the blood of a pregnant woman. This cause can be predicted and eliminated in advance. Most often, the conflict occurs when the embryo inherits the positive Rh factor of the father, and the negative Rh factor, the mother's body rejects the embryonic tissues that are alien to it. Constant monitoring of antibody titer and the introduction of anti-Rhesus immunoglobulins allows you to maintain and maintain pregnancy. In case of an immune conflict, progesterone preparations are also used to prevent miscarriage, which in this case has an immunomodulatory effect.

Reduced immunity

Reduced immunity during pregnancy also refers to immune causes. The body is simply not able to grow a new life in itself. You need to take care of yourself and recover before the next conception.

Anatomical causes of miscarriage

Anatomical causes of miscarriage are the most intractable. Malformations of the uterus are a serious reason for miscarriage. Sometimes you just have to deal with it.

Miscarriage between 12 and 22 weeks

Such a miscarriage is considered late. Its causes coincide with the causes of miscarriages in the early stages (anatomical, immune, infectious, endocrine).

At this time, miscarriage also occurs due to isthmic-cervical insufficiency - a weak cervix cannot hold the fetus and opens. For this reason, a miscarriage can occur in the 2nd or 3rd trimester. Isthmic-cervical insufficiency is observed in 15.0-42.7% of women suffering from miscarriage. Careful monitoring of the pregnant woman allows you to identify the problem in time and make surgical correction of the cervix before the onset of childbirth.

In isthmic-cervical insufficiency, there is only one method of treatment - mechanical narrowing of the cervical canal. To do this, the neck is either sewn up or a special ring is put on it. However, the latter method is less efficient, because the ring can easily slide off the neck, then it will no longer hold back the process of opening it.

After suturing, if necessary, it is possible to use antibiotics and drugs that normalize the microflora of the vagina. The treatment of the vagina and the control of the state of the seams are carried out daily for 5 days. Stitches are removed at 37-38 weeks and with premature onset of labor.

Isthmic-cervical insufficiency may be primary (for no apparent reason), may be the result of abortion or hormonal disorders (increased levels of androgens - male sex hormones or their precursors).

Miscarriage after 22 weeks

Such a loss is hard to forget. Obstetricians talk about premature birth after the 28th week of pregnancy. Traditionally, a child born after this period is considered viable. But medicine knows many cases when it was possible to save the life of earlier children.

We recommend that you be carefully examined for miscarriage, check the above factors. In addition to them, the cause of a miscarriage can be antiphospholipid syndrome, while the woman's body perceives the child as something alien and rejects it. This disease, like the others listed, can be corrected; you have a very real chance of bearing a child.

Miscarriages due to hemostasis disorders

All of the above causes account for only 30-40%. Up to 70% of miscarriages are caused by disorders in the blood coagulation system (hemostasis).

Blood coagulation disorders leading to pregnancy loss can be divided into thrombophilic (increased clotting) and hemorrhagic (bleeding tendencies). Both of these extremes are dangerous to the fetus. Various disorders leading to the formation of small blood clots lead to the fact that the fetus loses sufficient blood supply, development is disturbed and the fetus is rejected.

The main hemorrhagic changes can appear even in childhood in the form of increased bleeding during cuts, tooth extractions, the onset of menstruation. But sometimes they declare themselves only during pregnancy and are the cause of a miscarriage. Bleeding in the early stages and detachment of the chorion is difficult to stop.

You may not guess, but incomprehensible headaches, weakness, fatigue, temporary loss of smell or hearing may be symptoms of disorders in the blood coagulation system.

When planning a pregnancy, a genetic examination should be carried out and, if necessary, treatment should be started.

It is advisable to be examined for hidden hemostasis defects even for those who consider themselves healthy. This will allow you to predict the occurrence of complications and prevent loss. Early therapy can prevent miscarriage at 98% of cases. If defects in hemostasis are already detected during pregnancy, it can be difficult to maintain it.

What to do after a miscarriage?

Find the cause! The ideal option is to be examined by future parents: it is much more reasonable to postpone conception and spend two or three months to identify the causes than to risk getting pregnant again, spend two months waiting, and then lose everything again and still go to the doctors.

Until you understand the reason, it will not evaporate. In most cases, the answers lie on the surface. Take care of your health and your future baby.

Sign up for a consultation with an obstetrician-gynecologist by phone +7 (495) 150-60-01

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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

The loss of a child during pregnancy due to miscarriage or stillbirth is still a taboo topic around the world, which is associated with condemnation or a sense of shame. Many women who lose a child during pregnancy or childbirth continue to receive neither the proper care nor the respect they deserve. 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.

Worldwide, women's access to health services varies by country of residence, with hospitals and outpatient facilities very often under-resourced and understaffed in many countries. As varied as the experience of bereaved women, stigma, guilt and shame are common themes around the world. Women who have lost their children have shared personal experiences that they felt they had to keep their grief quiet, either because miscarriages or stillbirths remain common or because people perceive them as inevitable.

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 a very 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.

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.

Larai's story

There are many possible causes for miscarriages or stillbirths, from fetal abnormalities to maternal age to 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, avoidance of 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.

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. "

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

“I've been dealing with infertility 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 delivery, many of which could have been prevented with quality care and proper supervision of the woman in labour.

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.

Emilia, 36, shopkeeper, Colombia

“When my baby was stillborn at 32 weeks, we already gave him a name. The doctor referred me for an ultrasound examination, during which he told me that the child 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.

Emilia's story

The 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.

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.

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.

However, many women, even those living 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."

Depending on the rules of the particular medical facility, stillborn bodies may be treated as clinical waste and 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.

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.