What happened is not said to me: what is a missed abortion
'13.12.2018'
Source: Billboard Daily
This is the story of the architect Oksana Ivaschenko, who lost her pregnancy and decided to tell about it - despite the fact that such things are not discussed in Russia. By request Posters Daily The doctors explained why this happens, and the perinatal psychologist told how to talk about such losses.
We are from those couples who are planning a pregnancy in advance: gradually we got rid of bad habits, we were examined. We were preparing. Everything happened in about six months, which seems normal to me for our age and lifestyle.
Pregnancy lasted seven to eight weeks. When I came to the next ultrasound, which was necessary to hear the heartbeat, he was not there. The doctor said coolly: “There is no heartbeat. Fading. This must be stopped: in the morning, on an empty stomach, come to such an address. ” And that's all. Foreigners call this silent miscarriage - "silent miscarriage." I can’t say that I lost a child, that I had a child and that he died. Not. I did not have a child. I had a pregnancy and, as it turned out later, a male embryo. He had a strong chromosomal disorder, and he was not viable.
Twenty percent of women experience a frozen pregnancy in any country in the world. As women age, this percentage increases.
It doesn't matter if you were prepared. There are things that are stronger than us, for example, our brain filled with hormones. This is a self-switching mechanism of the female, which is stronger than there is little, and it is difficult to turn it off or pause.
When I was able to speak, I asked the doctor: “And what kind of statistics?”. "Twenty percent". Why I knew nothing about it. Why don't moms, sisters, friends, colleagues talk about this? If it is 20%, then at least 10 from 50 women with whom I communicate closely had the same thing. He answered me: “No one talks about this at all.”
It is not accepted
Pregnancy and childbirth in Russia are shrouded in prejudice more than other areas of medicine: it is believed that you should not take pictures of an ultrasound machine, many do not recommend having a haircut during pregnancy, sometimes you are baptized by “uzists”.
Only now I realized that the society that invented concealing a pregnancy before 12 – 14 weeks knows perfectly well that every fifth family will lose this pregnancy.
About his pregnancy before 12 – 14 weeks is also not to say. This is an unspoken rule. When you start to get to the bottom of why it needs to be kept secret, people reluctantly answer: "All sorts of things can happen." Only now I realized that the society that invented concealing a pregnancy before 12 – 14 weeks knows perfectly well that every fifth family will lose this pregnancy.
If you think about it, it happens almost more often than broken arms and legs. You need to learn how to talk about it. Many women do not talk about it because they feel shame, guilt, lack of understanding of what happened, how to tell your man, the fear that it will happen again. When I look at two thousand of my Facebook friends, I understand that this problem has touched or will affect four hundred of my acquaintances, both men and women.
Women's business
I would like everyone to understand: missed abortion is not a story about the female share. This is a problem of two. It seems to me that a geneticist or gynecologist should not only one woman call into the office. He should say: “Your husband is sitting in the hallway? Call him. Half of his genes. ”
It is normal to plan a child together, and bring up and experience losses together. Yes, a woman is experiencing more strongly, because she is biologically connected with the fetus, but a man is experiencing on a par with a woman, because she is absolutely helpless in this situation.
When you go to Russian-speaking women's forums for missed abortion, families and careers collapse there, sometimes women become pregnant, not even to her husband, and then they end up losing alone. Then women start to blame themselves endlessly. Three months after the experience, as I was told by a geneticist, a second round of grief may begin: a husband and wife begin to quarrel, accuse each other, comes to divorce. That's the way our psyche works, which is always looking for answers.
I finally realized that I had to write and talk about this when I visited a Russian website dedicated to a frozen pregnancy, where I read: “We deliberately don’t remember the role of a man in this difficult process, because you’re going through everything that happened to you in private with myself". In parallel, I had open American and English sites on this topic, where there are brochures for relatives and for the husband, with which my return to normalcy began. It said: “No matter how strong your grief is, do not forget that your family needs you and your support, your husband is also very hard now.” On American websites they write: “As though you would not like to withdraw into yourself right now, please try not to do this.”
Men are extremely hard going through and do not know who to talk to. They do not even understand why all this happened, how to talk about it? What to do next?
My husband had a post effect. At first he was great. Every second was with me, helped and supported. On each ultrasound, at the reception at the surgeon, after surgery. But a week later, he, a powerful, masculine man, drove down. I just saw how he did not go to work, silently, without breakfast, sat down in his pajamas in the kitchen, and when the eleventh series of Sherlock went, I realized that I had to calm down. I stopped wandering around like a ghost in the apartment, washed my head, cooked dinner and called our close friends. I really wanted to make it clear to my husband that I empathize with him, I am grateful for my resilience and we will go on slowly, right now. The most important thing is that any of the doctors will say - that one, even three consecutive missed pregnancies, as was Mark Zuckerberg and his wife, is not a sentence.
It just happened. This is a random number machine, and now you have such a number. Not because you have curly hair or you are 34 of the year.
Work with bad news
Doctors first of all say that this is a normal situation. But it's hard to survive: how is it? Yesterday you were pregnant, and today is no longer. At this moment you feel absolutely lonely. It seems to you that this happened only with you, and it will seem so to you until you start talking about it so sincerely that others want to say: “Listen, we didn’t tell anyone, but it was the same with us.”
Many say that the support that others are trying to provide is hard for them. People do not know how to do it. We don't have bad news ethics. When we are told: “Someone died for me” or “I have such a disease”, we often do not know what to answer.
I know that my experience can be useful to others. In general, we could have stopped and changed a lot on earth if we could talk
Pregnancy in our view is something magical. Everyone is so cool, everything is so great on Facebook, everyone gives birth to their wonderful babies. It is not even accepted to hint that sometimes not everything is so rosy. And you live in this magical world, and then lie on the ultrasound and you are told: "The heart has stopped." And you think, “How is it? After all, everyone is so cool. " After all, we only put on the beautiful things, and leave the problems to ourselves.
Pregnancy is not only a great time. This is the most complex process in the body, comparable to the formation of the universe. If we were aware of this, the risk would become more clear. I know that my experience can be useful to others. In general, we could have stopped and changed a lot on earth if we could talk. Apparently, only our generation will be able to tell this to their daughters.
Alla Politova
Professor of the Department of Women's Diseases and Reproductive Health of the National Medical and Surgical Center. N.I.Pirogova
There may be several reasons for missed abortion: genetic and chromosomal abnormalities of the embryo, violation of the anatomy of the genital organs, chronic infectious diseases of the pelvic organs of the mother, pathological conditions of the endometrium, disorders of the blood coagulation system. In some cases, it is not possible to establish the cause of missed abortion, the doctor may suggest, but it is impossible to identify objective data. Sports, travel, sex, work are not causes of missed abortion. The frequency of miscarriage, according to WHO, is 15 – 20%, depending on the age of the mother. In Russia, miscarriage is observed in 10 – 25% cases of all desired pregnancies, and this number is growing.
Therefore, in preparation for pregnancy, treatment of chronic diseases is mandatory, assessment of the condition of vaginal microbiocenosis, getting rid of addictions, taking folic acid for two to four months before conception. Rehabilitation of women with a frozen pregnancy includes anti-inflammatory therapy and, if necessary, correction of immune disorders, correction of the vaginal microbiocenosis and hormonal therapy.
It is necessary to understand that even after several miscarriages in a row a woman has every chance of having a healthy child. After miscarriage, after several months of recovery of the physical and psycho-emotional state, if there are no other contraindications, the couple can again plan the pregnancy.
Elena Okuneva
Genetic doctor at Genotek Medical Genetic Center
Unfortunately, this can happen to every woman regardless of age, ethnicity at any gestational age. Even the highest diagnostic technologies will not always allow finding the cause of missed abortion: in more than 50% of cases, the cause remains unexplained.
The highest risk is during the first trimester. Genetic factors and chromosomal rearrangements in the embryo are most important in the first trimester. One of the causes of a non-developing pregnancy is an intrauterine infection, therefore testing for infections is compulsory for all pregnant and pregnancy-planning women.
Spontaneous gene abnormalities, autoimmune diseases, and other immunological disorders can also cause fetal death before 12 weeks of pregnancy. One of the causes of abortion, to which little attention is paid, is the abnormal shape of the uterus. Smoking, drugs, alcohol, medicines can lead to disruption of the normal development of the embryo and fetus, the formation of defects.
According to the American Society of Obstetricians and Gynecologists, the link between early pregnancy loss and the older and late reproductive age of the mother and a large number of previous miscarriages is most reliably proven.
Tatyana Varzayeva
perinatal psychologist
Loss of pregnancy at any time can be very traumatic. However, women (and other family members who need support) often do not even know that, in principle, such assistance can be provided. Sometimes psychologists are not addressed for fear that they will not be able to understand everything correctly, and they will have to talk (and thus worry again) about the loss, and this is very painful.
Often, benevolent relatives, consoling a woman, underestimate the magnitude of her loss, do not consider it necessary to live this grief as a loss would be experienced, for example, of a parent. Sometimes they even communicate with a woman as if nothing had happened: “Well, you are young, you will give birth to more”. But this is the depreciation of this particular child, this particular lost pregnancy. And to hear it is very disappointing. Losing pregnancy, a woman loses not only the child. Lost image of himself as a mother, dreams of the future, bright hopes. And if the losses are recognized by the physical society, the non-material losses are not. And it hurts even more.
In case of injury after a missed abortion, I would recommend looking for a perinatal psychologist or psychologist who knows how to work with injuries and losses. The work will be aimed at experiencing the loss, careful maintenance of the passage of all stages of mourning: from denial to full recovery. Very helpful support group meetings.
Sometimes, in response to the question of how they have coped with the loss, I hear: they have gone to work with their heads. Such an approach is simply an escape from grief, which has turned out to be too strong to face him face to face. Good support will be all that helps to survive the loss, and not to pretend that it was not. It is important that someone be next to you say, “You're not guilty. You are not alone. I'm with you".
