Support women to cope with pregnancy loss

Belinda Nagawa (not real name), a 30-year-old businesswoman could not believe that her unborn baby was pronounced dead after a routine ultrasound scan examination when she had seen its heartbeat previously at 10 weeks of gestation. After a dilatation and curettage - a surgical procedure also called a D&C in which the cervix (lower, narrow part of the uterus) is expanded so that the uterine lining can be scraped with a spoon-shaped instrument to remove abnormal tissues, she developed paresthesia and her legs and arms became too weak.

 She was unable to walk, complained about insomnia, lost appetite and weight. She was resentful about her husband and friend’s lack of empathy for her. She felt guilty and selfish. She was ashamed of losing her unborn child. Subsequent consultations with a psychotherapist enabled her to share these feelings with her husband and she regained her feelings of competence and resumed care of her five-year old, whose care she had previously turned over to her mother.” This is a note from a counsellor on their patient who was dealing with a miscarriage.”

Taking into account the number of known and unknown miscarriages, there is a greater chance of miscarriage than not. As alarming as this statement may sound, illustration of loss of pregnancy indicates it is a commonly occurring event. But just because it is a common occurrence, it does not make it easier for women that experience it.

Not much attention, support and care is offered to women who lose their babies yet they get to suffer effects some of which are lifelong. This is why we need to dedicate greater efforts to increase awareness on the issue, speak about it and address it more effectively.

For the whole of last month, millions of mothers worldwide were celebrating Mothers’ Day yet the day may have been specifically triggering and devastating to women that have experienced a miscarriage.

A miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Some women have a miscarriage before they even know they are pregnant. There are many known causes to miscarriages, which could be either fetal or maternal. The most common, however, are fetal causes, which are because of problems with chromosomes.

In fact, about a half of miscarriages occur when a fertilised egg gets the wrong number of chromosomes, something that happens by chance and not genetically passed over. Chromosomes are the structures in our cells that hold genes with each person having 23 pairs.

A common example of chromosome problems that may cause miscarriage includes blighted ovum, where an embryo implants but does not develop into a baby. This is usually seen by dark brown vaginal bleeding early in pregnancy, problems with the uterus or cervix such as having a septate uterus where a band of tissue called the septum divides the uterus into two sections, fibroids and cervical insufficiency.

According to Dr Veronica Nabirye, a medic passionate about women’s issues, some of the maternal causes include chronic conditions such as polycystic ovary syndrome (PCOS- a hormonal disorder that causes enlarged ovaries with small cysts, diabetes, hypertension, preeclampsia, tobacco and alcohol abuse.

Other causes include advanced mother’s age, obesity and sexually transmitted infections, among other reasons. Signs and symptoms usually range from passage of tissue to vaginal bleeding to lower abdominal pain as well as fever.

The most common treatment after miscarriage is dilation and curettage. It usually takes few weeks to a month or more for one’s body to recover from a miscarriage. However, it may take longer for one to recover emotionally.

Although about one in five women experience early pregnancy loss, the issue has never been given adequate attention on its causes of psychiatric morbidity and mental unwellness in our societies.

Author Rochanda Michell talks of a ‘deconstruction of identity’ of mothers after baby loss. Studies show effects of early pregnancy loss as significant emotional burden manifesting as anxiety, depression and many other grief reactions which alter these women’s psychological, social and health status.

Studies have also shown that bereavement is a major risk factor for physical illness, grief, depression and anxiety. Central features include feelings of sadness often associated with feelings of loneliness. These grief reactions are usually preceded by a happy, expectant attitude and anticipation of having a child and having that bubble suddenly burst.

Furthermore, studies show that when depressive reactions complicate a grief reaction, it may not easily be resolved and it may make it hard to move on normally with their lives. A large percentage of women report not feeling supported by their spouse, as well as other people’s insensitive comments that they have to deal with.

Helping a victim seek therapy or psychiatric help, getting them counselling services, emotional support they prefer maybe listening to them, empathetic responses, validating their loss could go a long way in supporting victims to cope with the loss. Do not bring up conversations about future babies.

Support a woman today who has experienced miscarriages and grow and sustain those efforts for the good of all women.