Shravanthi was 32 weeks pregnant when her obstetrician told her the baby's heartbeat had stopped and she had suffered an intrauterine fetal demise. She and her husband are heartbroken.
Sheela was 11 weeks pregnant when she suffered a miscarriage. Having shared the happy news with everybody she knew, Sheela was upset about the miscarriage.
Sunita is 24 weeks pregnant. An ultrasound has revealed that her baby has a major birth defect because of which the baby may not survive if born. Her obstetrician has suggested termination of the pregnancy.
Sabira had gone to the hospital in labour. Unfortunately, the labour ended with a stillbirth.
It is well known that 12-15 per cent of confirmed pregnancies do not progress to term. In older women, this rate may be even higher. Early pregnancy loss, i.e. less than 20 weeks is experienced by one in five women.
Most women go on to have successful subsequent pregnancies. Nevertheless, the feeling of loss and grief may be difficult for some couples to handle.
Grieving is often complicated by feelings of self-blame, particularly when there is no medical explanation for the loss. It is important to remember that there is not much a woman can do to prevent a miscarriage, intrauterine demise, stillbirth or a birth defect.
How does grief and healing evolve?
Immediately after the event, your emotions may range from anger to despair. Remember that grief is not a sign of weakness. Do give yourself the time you need to mourn and accept what has happened.
Grief, in all individuals, follows a few well-described stages. You may or may not pass through each stage but the last stage is the most important to reach.
Common stages of grief
Common stages of grief include:
Denial: Faced with the news, you may refuse to believe it. You may seek opinions from another obstetrician or ask for another ultrasound scan to confirm the diagnosis. You may bargain with a higher power to make the bad news go away.
Anger: You may be angry at yourself, your husband or a higher power for letting this happen.
Guilt: As a woman, you may wonder if you could have avoided the pregnancy loss by being more careful. Don't blame yourself. There is very little a woman can do to avoid an unexpected pregnancy loss.
Depression: Your pain and sorrow may lead to symptoms of depression. These feelings usually resolve in time with strong support from your husband, family and friends. About 10 per cent of women may end up with clinical depression. If your depression is prolonged, you may need to seek professional support.
Acceptance: Each step in the grieving process brings you closer to acceptance. You will always carry the memory of your baby, but acceptance may ease your pain. Slowly, time and day-to-day living will help you overcome the acute pain.
You do not have to be alone
There is no need for you to keep your feelings bottled up. Your husband and you should be able to talk it over with each other. You have to be the most important support system for each other because no one else can feel the intensity of loss as much as the two of you. Your relationship with your husband might be particularly strained during this time. Remember, he is also grieving. However, he may not be able to express what he is feeling, which can make you feel he is not sharing your grief.
If you have friends or relatives who keep bringing up stories about other women who have lost a pregnancy or tell you what you should have done to avoid this loss, stay away from them. You do not need the aggravation of people who are insensitive or thoughtless at this time. Be direct and let them know when you don't want to discuss your pregnancy loss with them.
Planning your next pregnancy
Even though it seems good sense to plan another pregnancy immediately so that you can ‘forget' the pregnancy loss, it may not be such a good idea. Give yourself time to recover physically and emotionally. Only when you are fully recovered can you go through the next pregnancy with confidence. Talk to your obstetrician about the best form of birth control till you decide on your next pregnancy.
(The author is an obstetrician and gynaecologist)
