Miscarriage and stillbirth, because women need to talk about it

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The loss of a baby during pregnancy due to miscarriage or stillbirth is still a taboo topic around the world.

, linked - in some cases - to stigma and shame. In addition, many women still do not receive adequate care when their baby dies during pregnancy or delivery. The World Health Organization (WHO) wanted to highlight everything, inviting women from all over the world to share their experiences in this regard, with an article on the official website.


Estimates of the phenomenon

According to the WHO, miscarriage is one of the most common causes of baby loss during pregnancy. Estimates vary, although March of Dimes, an American nonprofit that focuses on maternal and child health, said that the miscarriage rate is 10-15% in women who know they are pregnant.

With regard to stillbirth, this is defined in various ways depending on the country, but in general when a baby dies before 28 weeks of pregnancy we speak of abortion, while we speak of stillbirth after 28 weeks, and Affected children are termed "stillborn".

As the gynecologist Laura Avagliano, expert in fetal death, told mymodernparents.com, "for the single families affected by this dramatic event, the week of pregnancy in which it occurred does not change things much. Whether it is what we define spontaneous abortion at 10 weeks, or a stillbirth at 26, the fact is that mom and dad lost their baby ”.

Official estimates speak of about 2,6 million children affected by stillbirth each year, with many of these deaths that - according to the WHO - would nevertheless be preventable. It must be said, however, that abortions and stillbirths are not always systematically recorded, even in developed countries, and this indicates that the numbers could be even higher.

Different but similar experiences all over the world

Women have access, all over the world, to very different types of health services: sometimes very well organized, other times absolutely lacking, with insufficient resources and personnel.

"Even though the experience of losing a child can be different from country to country, all over the world, the taboos of miscarriage,  however, stigma, shame and guilt emerge as common themes " reads the WHO article. In addition, as many stories reported by the WHO and also by the site mammenellarete.mymodernparents.com demonstrate, women who lose their children are often led to think that they must remain silent about their pain, both because the abortion and the stillbirth are considered very common, both because they are perceived as inevitable.

The psychological consequences

All of this can place a great deal of emotional and psychological burden on women. Some of the mothers who lose their baby in pregnancy may later experience mental health problems that last for months or years, even after having healthy children. To overcome these difficulties, sometimes these mothers can share their experiences on social networks (famous people such as Mark Zucherberg or Kimberly Van Der Beek, wife of actor James Van Der Beek have also done so).

Read also: A story to overcome the pain of an abortion

Spontaneous abortion: causes and prevention

There are many reasons why a miscarriage can occur, including fetal abnormalities, maternal age-related problems, infections, many of which are preventable, such as malaria and syphilis (particularly prevalent in low-income countries) or rubella from us.

WHO's general advice on abortion prevention focuses on the individual level mainly on:

  • healthy eating and physical activity, also for maintaining a healthy weight;
  • absence of smoking, drugs and alcohol;
  • limitation of caffeine;
  • stress control.

At a general and public health level, the strategies indicated by the WHO to reduce the number of abortions are:

  • improve access to antenatal care, given that in some areas of the world, women do not see a health care worker until they reach an advanced stage of pregnancy;
  • introduce the continuity of assistance by the midwife.

It is estimated that the treatment of infections in pregnancy, fetal heart rate monitoring and pregnancy surveillance, as part of an integrated care package, could save 1,3 million babies who could otherwise be stillborn.

Living conditions of women and the right to reproductive health

Even in 2022, some 200 million women would like to avoid becoming pregnant they do not have access to contraception systems. And when they become pregnant, 30 million of them do not give birth in a health facility and 45 million, instead, receive inadequate or no antenatal care. This puts both mother and baby at a much greater risk of complications and death.

Cultural practices such as the female genital mutilation and child marriage they are extremely harmful to girls' sexual and reproductive health and to the health of their children. Teenage mothers (aged 10 to 19) are much more likely to get infections than women aged 20 to 24.

Female genital mutilation, on the other hand, increases the risk of prolonged and difficult labor, bleeding and severe lacerations. Thus, the baby is much more likely to need resuscitation after delivery and to be exposed to a high risk of death during labor or after birth.

For all these reasons, it is essential to enable women to have all the necessary care available: this is vital for pregnancy to be a positive experience. The biomedical and physiological aspects of care must be combined with social, cultural, emotional and psychological support.

Abortion and stillbirth, to remove the taboo it is important to talk

Many women who have experienced a miscarriage or stillbirth report that they have not felt adequately listened to and treated by either health care providers or relatives and friends, and this can negatively impact bereavement.

To help mourn the loss of a child Healthcare professionals need to show sensitivity and empathy, understands how parents feel, provides clear information and senses that parents may need specific support. Providing human rights-based care that is respectful of the socio-cultural characteristics of parents and dignified is a prerequisite in the clinical competencies of maternal and neonatal care.

Finally, for friends and familyIt can be difficult to know what to say when someone you know well loses a baby in pregnancy, but sensitivity and empathy can always provide support. It is important to leave space for people to tell how they feel. Here are WHO advice on this.

3 things to never say to a mother who has lost her baby

- Everything happens for a reason, things had to go like this
- At least you know you can get pregnant
- At least you already have another healthy baby

- I'm very sorry, I can imagine how sad you feel
- How do you feel?
- I'm very sorry for your loss

Here are some stories from Mammenellarete.mymodernparents.com:

Many tell you "But it was only a 26 week fetus, for me it was simply my daughter"

I was carrying on a twin pregnancy. They were two little girls: it was beautiful until 2 September, the day of the morphology. Day I will never forget. The gynecologist put on the ultrasound probe and remained silent, her eyes filled with tears and there was freezing cold. It was total darkness. I thought it was all over. The little one below was gone. I felt a lot of pain. The other child was born premature: a little warrior weighing only 2 kilos with the determination of a lioness. She is now two years old and has a unique liveliness and sunshine. But I have an angel in heaven and one on earth. Many tell you "but she was only a 26 week fetus": to me she was simply my daughter!

Death in utero. But my Gingy will always be with me and her dad

At the seventeenth week the doctors told me that my little girl had a rare genetic syndrome. My husband and I obviously decided to continue the pregnancy. I was happy and was waiting for the baby to arrive. Unfortunately, one day, during an ultrasound, the doctor told me the terrible words: "There is no heartbeat". I gave birth to my Guinevere in the silence of a hospital room. Now her child rests in the cemetery of our city. Dad and I will always love her.

Miscarriage. But my pain will become my strength

I will never forget that check-up ultrasound at 12 weeks and that expression of the doctor when he said to me: “Madam, I'm sorry the pregnancy has stopped, there is no heartbeat”. I remember the tears, my husband's grief-soaked gaze and my sobs. Life certainly goes on and the only nice thing is that in all this chaos of emotions and in this sea of ​​pain I was lucky enough to have an amazing husband, a loving family and some really tough friends. And for this I will be eternally grateful to them. "Be grateful for the challenges, they are creating your strength."

Death in utero. I will never forget my little girl

I had two three and one year old boys when I realized I was pregnant again. Doctors later told me she was a sissy. But my joy did not last long, because unfortunately at the 27th week of her pregnancy I lost it. It was an incredible pain. Later I became pregnant again with a child, Chiara, who was born after nine months. But I will never be able to forget my little Giulia.



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