Perinatal loss is a problem faced by women around the world. Often families are left to deal with this traumatic situation alone, without the support they need and without knowing where to turn for support.
This is reported by the Dr. Evin website.
This text was written as part of the Vsluch Award, which recognizes educators in the field of women's health. The experts of this article are nominees of the award and specialists we trust.
Reproductive (perinatal) loss is defined as cases of undeveloped pregnancy, miscarriage, stillbirth, termination of pregnancy for medical reasons, as well as the death of a child during childbirth and in the first week after it. Behind the official dry definition are the fates of thousands of women who have faced this misfortune, because the problem affects every fifth family in the world. According to the statistics of the charity fund "Light in Hands", which helps those who have experienced such a loss, in 2018, about 500 perinatal deaths were recorded daily in Russia.
Can perinatal loss be prevented?
Up to 70% of perinatal losses are thought to be associated with preterm birth, but reproductive losses also occur in situations where pregnancies proceed as planned without complications. Women planning a pregnancy are often unaware that it can be terminated at any term, even late, and think that miscarriages only occur in the first trimester. Society believes that the causes of reproductive loss can be easily detected and prevented - while in some cases, detection is problematic.
It is not always possible to enumerate all the reasons why a pregnancy stops developing, delivery is problematic, or the baby dies in labor or shortly thereafter: each case is unique and requires medical investigation.
Attentive and careful attitude to your health is also, unfortunately, not a panacea. However, you should not neglect preparation for pregnancy (so-called pregravidarstvo). Talking to a specialist, discussing your complaints and diseases, tests and examinations allow you to timely detect problems that can lead to pregnancy failure, and take measures to prevent them.
"The causes of habitual (that is, repeated) failure of pregnancy can be pathologies of the blood coagulation system, autoimmune diseases, problems in the endocrine system, - says Olga Kaplina, the author of the course "You are healthy". - The so-called uterine factor is often overlooked. This is not only abnormal uterine development, but also acquired pathologies, such as polyps, chronic inflammation of the uterine mucosa (endometritis). It is important not to forget that two people are involved in the process of conception: therefore it is important to examine the partner as well".
Unfortunately, even a perfectly running pregnancy can end in reproductive loss, and 100% guarantees that everything will go safely, can not give any, even the most experienced, specialist. Nor is there a magic cure, the taking of which will completely safeguard against loss.
Support after perinatal loss: who needs it and what it should be like
Reproductive loss is an unexpected and very traumatic event. It seriously affects a woman's condition, primarily psychologically, but it is not commonly talked about: the topic rarely comes up in conversations and is not often discussed in the media. Many of those who have experienced such a loss do not receive the necessary support even from the closest relatives, which is why women decide to be left alone with their feelings.
"Many women are at best able to discuss their experiences within the family, but they are not ready to talk about it with someone else or take their story into the public domain. There are not enough sources of information that correctly talk about perinatal losses. Although now the situation is beginning to change for the better, and the topic is being heard more often in the media and social networks. The opportunity to speak out generates much-needed support and feedback, which is why many people also decide to share their experiences. After reading other people's stories, women realize that they are not the only ones who have experienced such a loss, and this helps them to process their grief, - explains Tatiana Pechurko, founder of the women's health media Reya.
"Families facing this are far from always able to get the help they need. This is largely due to the taboo nature of the topic. And this is not only the case in Russia, especially when it comes to dealing with the loss of unborn children. People around them often don't know how to react and support families in such moments, and parents themselves try not to bring up this topic, as if they are silent about the loss and, as a result, do not live it, - says Alexandra Kraus, founder of the Light in Hand Foundation.
It is not only the woman who needs help, the whole family needs it: the chance of divorce after perinatal loss increases significantly. The loss is lived not only by the woman, but also by the father of the child, and therefore it is important not to forget the men. Alexandra Kraus emphasizes that for the father, living with grief can be more challenging, as society does not encourage men to suffer and express their emotions openly.
If there are other children in the family, they also need help - it is not acceptable to keep silent, pretending that nothing has happened. It is important to talk about what happened, to help the children deal with their feelings, to be ready to talk to them and to provide the necessary support.
Unfortunately, there are not enough specialists who know how to work with perinatal losses, but today there are educational programs for psychologists. The Light in Hands Foundation, which has already graduated more than 22,000 specialists, is also involved in training.
How to properly support those who have suffered perinatal loss
Experts at the Light in Hand Foundation have written a small memo for loved ones to help gently support parents facing reproductive loss.
- Create the conditions for grief accommodationAllow parents to talk about their feelings and emotions, don't devalue the loss, don't try to make them "forget and move on" right away. Allow time to recover from the loss without rushing or pushing - as much time as needed.
- Help me say goodbye to my baby If it is possible and the parents want to do so, help organize the funeral. It is possible to say goodbye in other formats or not at all - it depends on the wishes of the parents.
- Talk to the other kidsIt is important to let older children talk about their experiences and feelings. If they feel guilty, explain that the loss is not their fault.
- Offer to seek psychological supportIf it is impossible to cope with stress and grief, it is worth turning to specialists - there is nothing wrong with that. Parents should not minimize and suppress their feelings, because this can only lead to more severe negative consequences for the psyche and the entire body.
Pregnancy after perinatal loss - what you need to know
Perinatal loss - regardless of the time frame in which it occurred - is an event that cannot help but affect mental health. Grieving often lasts for two years or longer, and women in this situation are more likely to experience anxiety and depression than those who have had a safe birth. They also experience them in subsequent pregnancies, even if they are uneventful.
Women have different attitudes towards pregnancy after loss. Some fear that the sad scenario will repeat itself, and therefore postpone a second pregnancy indefinitely, while others, on the contrary, would like to try again to give birth as soon as possible. There are many women who are ready for a new pregnancy: the Light in Hands Foundation found that if quality psychological and medical support were provided, more than 90% women would decide to have a new pregnancy after a loss.
"The time needed to recover from pregnancy loss depends on the term at which the pregnancy was terminated and the emotional state of the woman. If it happened before 10-12 weeks, it is possible to plan a new pregnancy immediately after the menstrual cycle is restored, i.e. in 1-2 months. If the pregnancy was terminated in 12-22 weeks, the time for recovery increases to 3 months. When terminating a pregnancy after 22 weeks, it is important to conduct not only a genetic study of the embryo, but also a full examination of the woman: to make an ultrasound of the pelvic organs, check for STIs, assess the hormonal profile, to exclude pathologies of the immune system and blood coagulation system. In addition, it is very important to take care of psychological health, - says Olga Kaplina.
She also explains that immediately after termination of pregnancy it is better to use a barrier method of contraception only after excluding pathologies of the blood clotting system and other contraindications, such as tumors or liver disorders, you can start using hormonal contraceptives - pills, vaginal rings, intrauterine spirals, subcutaneous implants. They should be prescribed and selected by a specialist.
Perinatal loss is not an easy experience, but it will be easier if you know that you are not alone. Understanding that such situations happen to others, support from friends and family, referral to qualified specialists, and taking care of yourself and your own health will help you cope.
It is also advisable to learn that a woman gave birth to a healthy son who grew in her peritoneum.
