- Alicia Hernandez @por_puesto
- BBC News World
3 mayo 2022
“I thought I was going to be a normal mom. And I was an empty-arms mom.”
Ileana García Mora corrects herself: “We are all normal. Life and death are natural processes, but one is more painful than the other.”
She defines herself as an activist for perinatal mourning, making it visible and talking regarding what to do when a child dies: “It is important to have information at hand, that mothers have options and, those close to them, minimum tools to touch the duel.
Because there was a time when she made decisions without knowing, in the midst of pain. Or where she had to listen to things like “better this way, that the body discards what is not useful.”
But “what doesn’t work” was Matías, his son, the one who was delivered, died, by caesarean section.
She speaks to BBC Mundo with Gabriel, almost a year old, clinging to her and nursing. Their son Gabriel is what they call a rainbow baby. And, like the optical phenomenon, for it to appear, there is first a storm.
A “I can’t find the heartbeat” triggered Ileana’s.
Ileana’s Storm
A Perinatal death is that loss that occurs from the 28th week of gestation and up to 28 days following delivery. Every year there are regarding 2 million such deaths in the world, one every 16 seconds, according to estimates by the World Health Organization (WHO).
On average, a pregnancy usually lasts between 37 and 42 weeks. The loss “is more frequent during the first trimester: it happens to one in four women,” explains the midwife (midwife) Celia Padilla. As it progresses, it happens less. “In the second trimester, it affects one in 50 women, and in the third, four in a thousand.”
In Ileana’s case, she felt that something was wrong at week 38. The doctor confirmed the worst news.
They gave her a choice: childbirth or cesarean section. She, following her experience, would recommend the most natural possible: “Giving birth to the child, even if he is dead, can make you process it.”
Padilla, who has been trained in perinatal losses and how to better go through this duel, confirms this. “It is hard to perform a vaginal delivery of a baby that is still alive, but it is the best for the physical recovery of the mother andfrom facing a next pregnancythe cesarean section is not ideal. Always, he points out, everything must be limited to the specific circumstances of the moment.
He also emphasizes the psychological benefit: “The process (of childbirth) puts you in orbit of what is happening. It is hard, but it places you in reality. C-section is a quick way to settle the issue, but it doesn’t help the grieving.”
Ileana was not told this. And she wanted to end everything now, be sedated.
“I want this dead baby taken out of me,” he said.
She didn’t say goodbye to him either, she was in shock. “I did not receive my son. It would have been better to say goodbye to him,” she laments. Today she questions why the clinic did not insist on seeing him.
When, days later, she realized everything that had happened, she had panic attacks: “I thought I was going to go crazy from the pain.”
Two weeks later she decided to seek help and start therapy.
A necessary protocol
Andrea von Hovelin, Chilean, is a gynecologist and was part of the advisory team of the Sunday Lawpromulgated in Chile last year and which seeks the implementation of a universal protocol in hospitals and clinics in the face of perinatal loss.
“The protocol must include respect for time and silence. You have to explain things as many times as necessary”maintains von Hovelin and refers specifically to the moment in which the mother receives the news.
From Spain, Celia Padilla also recommends that it take place “in a quiet environment and with the fewest people present.”
Von Hovelin also speaks of “the right to accompaniment, which exists in Chile, but when a mother has to give birth to a bus (baby) that is already deceased, many times it is not given.”
Both professionals stand out lo positive what can it be to see the deceased baby and say goodbye, as long as it is something chosen and voluntary. “It helps to locate yourself in the loss and be aware of reality,” says the midwife.
To do this, the protocol applied by Padilla includes do exactly the same as with a live newborn: bathe it, accommodate it, dress it.
“If it has been in the womb for a long time, the appearance can be shocking, so the family is informed.” They are then given as much time as they need to take photos and say goodbye.
“We also make a little box with the footprints, the umbilical cord clamp, a diaper. That way they take something home.Keeping memories can help grief on a psychological level,” says Padilla.
Jessica Rodriguez Czaplick, president of the Spanish Association of Perinatal Psychologypoints out that although these actions, seeing the baby, saying goodbye, saving memories or taking photos, “facilitate the elaboration of grief, They must be properly explained, reported very delicately and without forcing”.
Padilla and Von Hovelin agree that mothers who have suffered a loss they should not share space with other pregnant women, with mothers who are with their babies or “near a delivery room, where they hear children cry.”
And, of course, in an ideal world, during all this time there are psychologists specializing in perinatal grief accompanying them.
a taboo duel
“When I went back to work nobody said anything to me. Everyone fled from me as if I were death. People expect you to sweep it under the rugIleana recalls.
He recounts with indignation the string of phrases of supposed consolation that he heard such as “God knows what he is doing”, “God Needed an Angel” or “the human body knows what it gets out of.”
“Someone may find comfort in this. I don’t,” he says.
Perinatal grief “is unauthorized, unknown and taboo. Society silences him and does not allow the free expression of emotions to the mourners“, apunta la psicóloga Czaplick.
Von Hovelin points out that since “the son did not exist in the minds of others, they consider it a duel of the second order”. Plus, “is covered with the hope of the future, the idea that new children may come or that you think regarding those who need to be cared for. This generates guilt in the parents and more frequently in the mother.”
Although at first Ileana was not able to do anything that required a minimum of concentration, little by little she began to write down her small daily achievements -“Today I have painted a mandala”, “Today I have read a page of a book regarding grief”- .
Five months following the loss of his son beginning something that has been his way of breaking the taboo of perinatal mourning: he opened the account from instagram @lamamadematiass.
“I created her with no expectations. The only one was to heal myself.”
Also It made her see that she wasn’t alone.
“Losing a child in week 38 makes you feel like a weirdo, you even feel guilty. Thanks to the account, I connected with other moms who, in addition to the loss, had hereditary thrombophilia“, he says, referring to the disease that, following two years of travel, was diagnosed as the cause of Matías’ death.
And so he managed to create a community. “We heal together. I’m not a psychologist, but my experience is a flashlight. And it has made it possible for me to make sense of such a painful loss.”
With that light, he vindicates the duel: “There is fear of what they will say, They call us exaggerated, it’s wrong to be sad. Many have even been mocked. But no one should minimize the pain. Only you know the story behind your children.”
look for the rainbow
After the diagnosis of Ileana’s thrombophilia, The solution arrived -anticoagulants- and a new pregnancy. And with it, a new emotion: fear.
“It’s horny (strong). It’s a pregnancy of fear and fear that the same thing will happen”recalls.
The experts consulted maintain that there is no right time to seek a pregnancy once more following a loss, but it is important to respect a minimum not only for the physical recovery, also to do the duel correctly.
“It is normal for there to be pain, but if it is disabling, it is better not to seek a pregnancy,” advises Celia Padilla.
And along the same lines, the psychologist Jessica Rodríguez Czaplick points out: “Pregnancy can be sought as a form of hide the pain for the deceased baby. And this would really be a big mistake.”
For her part, Andrea von Hovelin stresses that, if it happens, “good support (for the mother) would be appropriate and understand that a new pregnancy will come with a higher share of anxiety.”
Ileana he was afraid, but he sustained it and, as he recommends, he also learned to live joy during your new pregnancy. “You have to have patience, self-compassion. Learn to trust.”
She finally had a rainbow pregnancy, that is to say, it came to fruition two years and 9 months following the loss of Matías, a deep mourning, hours of therapy.
You know that things may not go well, that there are moms who, no matter how hard they try, can’t find the rainbow behind the storm. She cradles Gabriel, who has fallen asleep in her arms. Ileana looks at him: “We have the right to believe in miracles.”
Recommendations of psychologists and health personnel
The experts remember that this is a personal process and each mother, couple and family is a world. But, like other duels, hOh, respect the times and emotions, as well as the way of living it of each person. The respect is key.
To the relatives: There are no words that can comfort, so accompany.
Avoid saying: “Keep going”, “Be strong”, “You’ll get out of this”, “You’ll have another one in no time”, “It’s better this way”, “Better now than later”, “You’re young, nothing happens” or “At least now you have another child.” These expressions do not comfort or lessen the pain.
What to say: “I can’t imagine the pain, but I’m here”, “I imagine it must be very hard”. A simple “I’m so sorry” or “What do you need?” can serve. It can be accompanied by a hug. Sometimes it’s just regarding being by their side, in silence, letting them know that you understand their pain and that you are present and supportive.
Parents must be clear that they can and they have the right to express their feelingsyour pain.
It is normal feel other emotions such as anger, sadness, emptiness and even hope. You have to give him space to all.
name your babybecause it existed.
Go through your grief in all its stages.
can be good to do farewell rituals (funeral, memory box). It can be valid in case there are sisters or brothers at home.
Make “tribe”: Meet and talk with people who have been through the same thing.
Ask for psychological help with experts in perinatal grief.
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